Vaccination is one of the most successful medical interventions that has saved the life of millions of people. Vaccination is particularly important in patients with multiple myeloma, who have an increased risk of infections due to the disease-inherent immune suppression, and because of the immune suppressive effects of therapy. Hence, all appropriate measures should be exploited, to elicit an effective immune response to common pathogens like influenza, pneumococci, varicella zoster virus, and to those bacteria and viruses (haemophilus influenzae, meningococci, and hepatitis) that frequently may pose a significant risk to patients with multiple myeloma. Patients after autologous, and specifically after allogeneic transplantation have severely reduced antibody titers, and therefore require a broader spectrum of vaccinations. Response to vaccination in myeloma often is less vigorous than in the general population, mandating either measurement of the postvaccination antibody titers and/or repeating the vaccination. Here, we compile the existing data on vaccination in multiple myeloma and provide recommendations for clinical practice.

1st Department of Medicine Center for Hematology Oncology and Palliatic Care Clinic Ottakring Vienna Austria

2 Medizinische Klinik und Poliklinik Universitätsklinikum Hamburg Eppendorf Hamburg Germany

CIMA IDISNA CIBERONC Clínica Universidad de Navarra Pamplona Spain

Department of Clinical Hematology and Cellular Therapy Hospital Saint Antoine Sorbonne University Paris France

Department of Clinical Hematology CHU of Liège Liège Belgium

Department of Hematology Amsterdam UMC VU University Amsterdam The Netherlands

Department of Hematology Ankara University Ankara Turkey

Department of Hematology Odense University Hospital University of Southern Denmark Odense Denmark

Department of Hematology UZ Leuven Leuven Belgium

Department of Hematooncology University Hospital Ostrava and Faculty of Medicine University of Ostrava Ostrava Czech Republic

Department of Internal Medicine 2 University Hospital Würzburg Würzburg Germany

Department of Medical Oncology and Hematology Cantonal Hospital St Gallen St Gallen Switzerland

Erasmus MC Cancer Institute Erasmus University of Rotterdam Rotterdam The Netherlands

Hematology and Medical Oncology Department of Clinical Therapeutics National and Kapodistrian University of Athens Athens Greece

Hôpital Claude Huriez Lille University Hospital Lille France

IBSAL Cancer Research Center University Hospital of Salamanca Salamanca Spain

INSERM UMR_S 938 Centre de Recherche Saint Antoine Team Proliferation and Differentiation of Stem Cells Assistance Publique Hôpitaux de Paris Hôpital Pitié Salpêtrière Service d'Hématologie Sorbonne Université Paris France

Interdisciplinary Tumor Center Faculty of Freiburg University of Freiburg Freiburg Germany

Internal Medicine 5 and National Center for Tumor Diseases University Hospital Heidelberg Heidelberg Germany

Myeloma Unit Division of Hematology Azienda Ospedaliero Universitaria Città della Salute e della Scienza Torino Italy

NCCC Newcastle upon Tyne Hospitals Trust Newcastle upon Tyne UK

Poitiers University Hospital Poitiers France

Seràgnoli Institute of Hematology Bologna University School of Medicine Bologna Italy

Service hematologie et thérapie cellulaire PRC cic 1402 Inserm CHU poitiers Poitiers France

The Institute of Cancer Research London UK

Unité de Génomique du Myélome University of Toulouse Toulouse France

Wilhelminen Cancer Research Institute c o 1st Department of Medicine Center for Oncology Hematology and Palliative Care Clinic Ottakring Vienna Austria

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