Key Clinical Summary:

• Design/Population: This multicenter, retrospective study evaluated 41 patients with multiple myeloma who received measles-mumps-rubella vaccine during daratumumab maintenance following autologous stem-cell transplantation
• Key Outcomes: No cases of vaccine-related measles-mumps-rubella infection, hospitalization, or death were observed. Adverse events were infrequent and mild, including acute sinusitis and COVID-19 infection with isolated reports of rash, headache, and arthralgia. Patients were largely receiving monthly daratumumab, often in combination regimens, with low baseline IgG levels.
• Clinical Relevance: Measles-mumps-rubella vaccination appears safe for administration in post-transplantation patients with multiple myeloma receiving daratumumab maintenance, supporting reconsideration of live-attenuated vaccination in select immunocompromised populations and addressing infection risk amid rising measles incidences.

Results from a retrospective study suggest that measles-mumps-rubella (MMR) vaccination appears safe in patients with multiple myeloma receiving daratumumab maintenance following autologous stem-cell transplantation (ASCT). 

These results were presented at the Hematology/Oncology Pharmacy Association (HOPA) Annual Meeting in New Orleans, Louisiana, by James Davis, PharmD, University of South Carolina, Charleston, South Carolina.

In this multicenter study, researchers enrolled 41 patients undergoing daratumumab maintenance after ASCT to receive MMR vaccination at the discretion of the treating physician. Patient characteristics and safety outcomes were evaluated. 

At time of vaccination, the median immunoglobulin level was 482 mg/dL, with 26% of patients receiving intravenous immunoglobulin. Patients completed ASCT at a median of 4.4 months prior to starting daratumumab maintenance, and the median time from ASCT to vaccination was 25.2 months. Daratumumab was administered either alone (34%) or in combination with lenalidomide (52%), pomalidomide (7%), or with a proteasome inhibitor (7%). Most patients received daratumumab monthly (95%), and patients received a median of 20.2 months of daratumumab.

The most common adverse events included acute sinusitis (5%) and COVID-19 infection (5%), occurring at a median of 8 days post-vaccination. Rash, headache, and arthralgia were each reported in 1 patient. No cases of vaccine-related MMR infection were observed, and no hospitalizations or deaths occurred following vaccination. 

“Our findings suggest MMR vaccination in immunocompromised patients with multiple myeloma receiving daratumumab 24 months after ASCT is safe,” concluded Dr Davis. “MMR vaccination is important for these patients because of the rising rates of vaccine hesitancy in the general population and the recent increase in confirmed measles cases in the United States.”

Source:

Davis JA. Safety of live-attenuated MMR vaccination in patients with multiple myeloma receiving daratumumab after autologous stem-cell transplantation. Presented at the HOPA Annual Conference. March 25-27, 2026. New Orleans, Louisiana. CR04.