Secondary Immunodeficiency in Hematological Malignancies: Focus on Multiple Myeloma and Chronic Lymphocytic Leukemia

• Published in: Frontiers in immunology Vol. 12; p. 738915
• Main Authors: Allegra, Alessandro, Tonacci, Alessandro, Musolino, Caterina, Pioggia, Giovanni, Gangemi, Sebastiano
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 25.10.2021
• Subjects: Animals; chronic lymphocytic leukemia; Humans; Immunocompromised Host; immunodeficiency; Immunogenicity, Vaccine; Immunologic Deficiency Syndromes - epidemiology; Immunologic Deficiency Syndromes - immunology; Immunologic Deficiency Syndromes - therapy; Immunology; Incidence; infection; Leukemia, Lymphocytic, Chronic, B-Cell - epidemiology; Leukemia, Lymphocytic, Chronic, B-Cell - immunology; Leukemia, Lymphocytic, Chronic, B-Cell - therapy; multiple myeloma; Multiple Myeloma - epidemiology; Multiple Myeloma - immunology; Multiple Myeloma - therapy; Opportunistic Infections - epidemiology; Opportunistic Infections - immunology; Opportunistic Infections - prevention & control; Risk Factors; Vaccination; Vaccine Efficacy; Vaccines - administration & dosage; Vaccines - adverse effects; infection; multiple myeloma; immunodeficiency; chronic lymphocytic leukemia; vaccination
• ISSN: 1664-3224; 1664-3224
• DOI: 10.3389/fimmu.2021.738915

Secondary immunodeficiency is reported in most patients with hematological malignancies such as chronic lymphocytic leukemia and multiple myeloma. The aim of our review was to evaluate the existing literature data on patients with hematological malignancies, with regard to the effect of immunodeficiency on the outcome, the clinical and therapeutic approach, and on the onset of noninfectious complications, including thrombosis, pleural effusion, and orofacial complications. Immunodeficiency in these patients has an intense impact on their risk of infection, in turn increasing morbidity and mortality even years after treatment completion. However, these patients with increased risk of severe infectious diseases could be treated with adequate vaccination coverage, but the vaccines’ administration can be associated with a decreased immune response and an augmented risk of adverse reactions. Probably, immunogenicity of the inactivated is analogous to that of healthy subjects at the moment of vaccination, but it undertakes a gradual weakening over time. However, the dispensation of live attenuated viral vaccines is controversial because of the risk of the activation of vaccine viruses. A particular immunization schedule should be employed according to the clinical and immunological condition of each of these patients to guarantee a constant immune response without any risks to the patients’ health.