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    Imaging, QoL and Patient-Reported Outcome and Supportive Care

    Category: Imaging, QoL and Patient-Reported Outcome and Supportive Care

    Measles antibody IgG levels in treatment exposed patients with Multiple Myeloma

    (PA-128) Measles Antibody IgG Levels in Treatment Exposed Patients with Multiple Myeloma

    Wednesday, September 17, 2025

    Introduction:      As of May 2025, the United States has reported over 1,046 confirmed measles cases across 31 states, surpassing the 285 cases reported in 2024. Ninety-seven percent of cases are in unvaccinated individuals. Eleven percent of cases required hospitalization, and three cases resulted in death (Centers for Disease Control and Prevention, 2025). The measles, mumps, and rubella (MMR) vaccine is contraindicated in patients with multiple myeloma (MM) within two years post autologous stem cell transplant (ASCT) due to immunosuppression caused by myeloablative chemotherapy. Two years post ASCT, many patients cannot receive the MMR vaccine because of ongoing immunosuppressive therapy for which live vaccines remain contraindicated. In addition, the impact of immunotherapies on measles immunity has not been reported. We sought to better understand immunity to measles in patients with MM to assess risk as measles rates rise.

    Methods:   Data was collected via chart extraction using the electronic medical record from February to May 2025. The sample included patients with MM treated at the Wilmot Cancer Institute who expressed concern about contracting measles. Data was collected about diagnosis, time since diagnosis, duration on MM therapy, current treatment regimen, time on current treatment regimen, ASCT history, chimeric antigen receptor t-cell therapy history, intravenous immunoglobulin (IVIG) infusion history, measles antibody IgG level, and post ASCT MMR vaccine history. Patients with MM or Smoldering MM were included. Our review was limited by not knowing original vaccination status and antibody levels.

    Results:   Twenty-one patients requested measles IgG antibody levels. Of this sample, ten patients had negative or equivocal results, indicating inadequate antibodies toward the measles virus. Of those with negative results, the time since diagnosis ranged from 13 to 117 months and 70% had ASCT.  In addition, 90% of these patients remain on treatment and 80% are not eligible to receive MMR vaccine due to treatment related immunosuppression. Fifty-five percent of patients on daratumumab had negative results and 44% of patients who had ASCT had negative results. Among patients who have received IVIG, 75% had positive levels. Of the two patients that did receive post-transplant MMR vaccination, one had a positive result. The patient with a negative result received a second ASCT after MMR vaccination. We will continue to check for late breaking data through 8/31/25 and fully characterize patients with and without immunity.

    Conclusions:   Patients with MM are at an increased risk of contracting measles due to immunosuppression and research is needed to determine which patients are at highest risk. Updated clinical guidelines are needed for re-vaccinating patients post-ASCT while on active therapy. Research toward other means of protection for patients, such as the use of IVIG, may help safeguard this at-risk population.