Rob Miani joined the MMRF team as Chief Financial Officer in 2016. Most recently he was the Vice President of Finance and Corporate Controller of Aptuit, LLC, a global contract research organization providing integrated early discovery to mid-phase drug development services in the pharmaceutical industry. Rob has over 20 years of leadership experience in the private and public sectors, holding managerial positions in the renewable energy, private equity, Internet and technology industries, including Davenport Newberry, Oak Investment Partners and INT Media Group. He began his career with Arthur Anderson LLP in the Assurance and Business Advisory Services Division. Rob is a CPA and received his BS degree in Accounting from Fairfield University.
Infections and Vaccinations in Multiple Myeloma
Multiple myeloma is a cancer affecting plasma cells, a type of immune cell that circulates in the blood. Plasma cells make antibodies that help to protect the body against infection. In myeloma, the number of normal functional antibodies is greatly reduced. Moreover, myeloma cells make abnormal antibodies, called M proteins, which are not useful in fighting infection—making patients more vulnerable to infection.
Patients with myeloma have a deficient immune system, and the myeloma itself or the treatment used to fight it can put patients at greater risk of infection—indeed, the risk of infection may be 7 to 10 times higher for myeloma patients than in the general population. Types of infections a patient may get include urinary tract infections, pneumonia (an infection of the lungs), septicemia (blood infection), fungal infections, and viral infections such as influenza and varicella zoster (shingles).
To manage this infection risk, preventive strategies (called prophylaxis) are recommended. Prophylaxis is usually recommended for patients receiving corticosteroids, high-dose therapy, and stem cell transplant. Patients with recurrent life-threatening infections should also receive prophylaxis. Strategies for prophylaxis include using intravenous immunoglobulin (IVIG), antibiotics, growth factors, and vaccines.
Influenza
Myeloma patients are also 10 times more likely to get influenza, with one in five getting sick from the flu every year. Annual influenza vaccination is therefore recommended for myeloma patients.
Pneumonia
Two in three infection-related deaths in myeloma patients are caused by pneumonia. The Centers for Disease Control and Prevention (CDC) and the National Comprehensive Cancer Network (NCCN) recommend vaccinating myeloma patients with a pneumococcal vaccine.
Shingles
Shingles (also called herpes zoster)—a painful rash—is caused when the virus that causes chicken pox (varicella zoster) is reactivated. Shingles occurs with decreased immunity, for example in patients with multiple myeloma receiving certain treatments – like the proteasome inhibitors (Velcade, Kyprolis, and Ninlaro) and the monoclonal antibody Darzalex—and in those undergoing stem cell transplant. Antiviral agents such as acyclovir or valacyclovir can protect against shingles. And a vaccine to prevent shingles is also available.
Your health care team will outline the appropriate preventive strategies for you.
Patient Navigators in the MMRF Patient Support Center are always available at 866-603-6628 or [email protected] to help answer any questions you have or to help you find the right resources to help in your fight against myeloma.
Additional Resources
Disease Overview.
Symptoms & Side effects.
Proteasome Inhibitors.
