Prevention of viral infections in patients with multiple myeloma: the role of antiviral prophylaxis and immunization.
Viral infections are a major cause of morbidity and mortality in patients with myeloma. Over the last decade, treatment of myeloma has undergone a paradigm shift with the use of immunomodulatory drugs, proteasome inhibitors and autologous stem cell transplantation, resulting in changes to risk periods and risk factors for viral infection. Viral infections affecting this patient group fall broadly into reactivation of latent viral infections (e.g., varicella zoster and hepatitis B) and acquisition of acute viral respiratory infections. The periods following autologous stem cell transplantation and progressive disease are identified as increased risk for viral infections. This review focuses on evidence-based prevention strategies for key viral infections, particularly approaches to prophylaxis and immunization. Recommended prevention strategies are summarized using a risk-stratified approach. Further studies evaluating preventative measures for newly identified risk periods are required.
a 1 Department of Infectious Diseases, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.|b 2 Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria, Australia.
Benjamin W
BW
Teh
a 1 Department of Infectious Diseases, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.|c 3 Victorian Infectious Diseases Service, Doherty Institute for Infection and Immunity, Parkville, Victoria, Australia.
Monica A
MA
Slavin
b 2 Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria, Australia.|d 4 Department of Haematology, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.
Simon J
SJ
Harrison
a 1 Department of Infectious Diseases, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.|e 5 Department of Medicine, University of Melbourne, Victoria, Australia.
Leon J
LJ
Worth
D000998:Antiviral Agents / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D009101:Multiple Myeloma / Q000150:complications* / Q000628:therapy*; D014611:Vaccination; D014777:Virus Diseases / Q000188:drug therapy / Q000517:prevention & control*
D000998:Antiviral Agents
myeloma; prevention; risk; treatment; viral infection