BACKGROUND: Infections are a common reason for hospitalization and death in multiple myeloma (MM). Although pneumococcal vaccination (PV) and influenza vaccination (FV) are recommended for MM patients, data on vaccination status and outcomes are limited in MM. MATERIALS AND METHODS: We utilized data from the global, prospective, observational INSIGHT MM study to analyze FV and PV rates and associated outcomes of patients with MM enrolled 2016-2019. RESULTS: Of the 4307 patients enrolled, 2543 and 2500 had study-entry data on FV and PV status. Overall vaccination rates were low (FV 39.6%, PV 30.2%) and varied by region. On separate multivariable analyses of overall survival (OS) by Cox model, FV in the prior 2 years and PV in the prior 5 years impacted OS (vs. no vaccination; FV: HR, 0.73; 95% CI, 0.60-0.90; P = .003; PV: HR, 0.51; 95% CI, 0.42-0.63; P < .0001) when adjusted for age, region, performance status, disease stage, cytogenetics at diagnosis, MM symptoms, disease status, time since diagnosis, and prior transplant. Proportions of deaths due to infections were lower among vaccinated versus non-vaccinated patients (FV: 9.8% vs. 15.3%, P = .142; PV: 9.9% vs. 18.0%, P = .032). Patients with FV had generally lower health resource utilization (HRU) versus patients without FV; patients with PV had higher or similar HRU versus patients without PV. CONCLUSION: Vaccination is important in MM and should be encouraged. Vaccination status should be recorded in prospective clinical trials as it may affect survival. This trial was registered at www. CLINICALTRIALS: gov as #NCT02761187.

1st Affiliated Hospital Soochow University Suzhou Jiangsu P R China

Aurora Cancer Care Advocate Aurora Research Institute Advocate Aurora Health Milwaukee WI

China Medical University Hospital Taichung City P R China

Department of Clinical Therapeutics National and Kapodistrian University of Athens School of Medicine Athens Greece

Department of Hemato oncology University Hospital Ostrava and Faculty of Medicine University of Ostrava Ostrava Czech Republic

Department of Hematology Clinica São Germano and Santa Casa Medical School São Paulo Brazil

Department of Hematology Oncology Mount Sinai School of Medicine New York NY

Department of Hematology Tennessee Oncology and Sarah Cannon Research Institute Nashville TN

Department of Hematology UMAE Hospital de Especialidades Centro Medico La Raza IMSS Mexico City Mexico

Department of Lymphoma and Myeloma The University of Texas M D Anderson Cancer Center Houston TX

Department of Malignant Hematology Barbara Ann Karmanos Cancer Institute Wayne State University School of Medicine Detroit MI

Division of Hematology University of Torino Torino Italy

Hematology Department Hospital Universitario de Salamanca CIBERONC Salamanca Spain

Indiana University School of Medicine Indianapolis IN

Leeds Cancer Centre Leeds Teaching Hospitals Trust Leeds UK

Levine Cancer Institute Charlotte NC

Malignant Haematology and Stem Cell Transplantation Service Alfred Health Monash University Melbourne Australia

Mijelom CRO Croatian Myeloma Support Association Zagreb Croatia

Myeloma Patients Europe Brussels Belgium

Perlmutter Cancer Center NYU Langone New York NY

Pôle Régional de Cancérologie Department of Hematology CHU La Milétrie Poitiers Poitiers France

Rocky Mountain Cancer Centers US Oncology Research Denver CO

Takeda Development Center Americas Inc Lexington MA

Takeda Pharmaceuticals U S A Inc Lexington MA

The Central Nebraska Myeloma Support Group Grand Island NE

University Medical Center Hamburg Eppendorf Hamburg Germany

University of Arkansas for Medical Sciences Little Rock AR

University of California San Diego La Jolla CA

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ClinicalTrials.gov
NCT02761187