2327. Safety of Live-attenuated Zoster Vaccination in Multiple Myeloma Patients Receiving Maintenance Lenalidomide after Autologous Stem Cell Transplantation.
Session: Poster Abstract Session: Transplants: Infection Epidemiology and Outcome in Stem Cell Transplantation
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • zoster vaccine MM poster upload.pdf (694.5 kB)
  • Background: The safety of zoster vaccine in multiple myeloma patients on maintenance lenalidomide after autologous hematopoietic stem cell transplantation (auto-HSCT) is unknown. At our institution the zoster vaccine is given typically around two years post auto-HSCT provided patients are not on any immunosupression.

    Methods: We conducted a retrospective study of multiple myeloma patients seen at Dana-Farber Cancer Institute, Boston, MA between May 2007 and January 2014 who met the following criteria: received an auto-HSCT, were on lenalidomide maintenance, and received a dose of live-attenuated zoster vaccine (Zostavax). Patients were excluded if they were taking acyclovir or valacyclovir for zoster prophylaxis when they received the vaccine, or started acyclovir or valacylcovir for prophylaxis within 42 days after vaccination. Adverse events (AEs) were recorded until 42 days after vaccination.

    Results: There were 70 patients who met study criteria. The median age was 63 years (range 46-75), and 61.4% were male. The median time between transplant and vaccination was 25 months (range 19-62). Adverse events are listed in the table.
    AEs up to Day 42 n (%) 

    Rash

    2 (2.9)
    Worsening PNH*  1 (1.4)
    URI±  10 (14.3)
    Fever  1 (1.4)
    Hospitalization up to Day 42

    0 (0)

    Death up to Day 42 0 (0)

    Non-vesicular rash

    *The patient had post-herpetic neuralgia, in reported increased pain after vaccine administration

    ±Upper respiratory tract infection

     Conclusion: Zoster vaccine administered around 24 months after auto-HSCT was safe and well-tolerated in multiple myeloma patients on maintenance lenalidomide.

    Alisha Pandit, BA1, Houry Leblebjian, Pharm D2, Sarah P. Hammond, MD3, Jacob Laubach, MD1, Paul G. Richardson, MD4, Lindsey R. Baden, MD5, Francisco M. Marty, MD, FIDSA6 and Nicolas C. Issa, MD5, (1)Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, (2)Pharmacy, Dana-Farber Cancer Institute, Boston, MA, (3)Infectious Diseases, Brigham and Women's Hospital, Boston, MA, (4)Harvard Medical School, Boston, MA, (5)Division of Infectious Diseases, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, (6)Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA

    Disclosures:

    A. Pandit, None

    H. Leblebjian, None

    S. P. Hammond, Merck: Investigator , Research support
    Ansun Biopharma: Investigator , Research support

    J. Laubach, None

    P. G. Richardson, None

    L. R. Baden, None

    F. M. Marty, Alexion: Scientific Advisor , Consulting fee
    Ansun: Investigator , Research support
    Astellas: Consultant and Investigator , Consulting fee and Research support
    Basilea: Conference speaker , Speaker honorarium
    Chimerix: Consultant and Investigator , Consulting fee and Research support
    Gilead: Consultant and Investigator , Consulting fee and Research support
    GlaxoSmithKline: Consultant and Investigator , Consulting fee and Research grant
    LFB, S.A.: Consultant , Consulting fee
    Merck: Consultant and Investigator , Consulting fee and Research support
    Shire: Consultant and Investigator , Consulting fee and Research support
    WHISCON: Investigator , Research support
    Pfizer: Course speaker , Speaker honorarium
    Fate Therapeutics: Scientific Advisor , Consulting fee

    N. C. Issa, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.