What is your re-immunization strategy after auto SCT for patients with myeloma on dara/len maintenance?

We do the same vaccination sequence according to BMT/CTN, whether they are on maintenance dara or not. Here is our schedule

Post autologous SCT vaccine

Interval Date Vaccine

Yearly Flu Vaccine

3-month post-transplant Pneumovax 20, Hib, hep A/hep B, polio, TDap, Shingrix

6 months post-transplant Pneu...

The BMT/CTN schedule has not been re-examined, unfortunately. Hib & polio are thankfully not a risk in the U.S. for now, and so these vaccinations do not have an appealing benefit:risk ratio - similar to MenACWY, MenB, and HPV.

Hepatitis A and B have individualized risk factors per the previous ACIP...

We follow TCT guidelines and avoid live vaccines.