Review ARTICLE

Front. Immunol., 03 June 2014 | http://dx.doi.org/10.3389/fimmu.2014.00257

Immune defects in the risk of infection and response to vaccination in monoclonal gammopathy of undetermined significance and multiple myeloma

  • 1Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
  • 2Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, UK
  • 3Department of Internal Medicine and Rheumatology, Martini Hospital, Groningen, Netherlands

The plasma cell proliferative disorders monoclonal gammopathy of undetermined significance (MGUS) and malignant multiple myeloma (MM) are characterized by an accumulation of transformed clonal plasma cells in the bone marrow and production of monoclonal immunoglobulin. They typically affect an older population, with median age of diagnosis of approximately 70 years. In both disorders, there is an increased risk of infection due to the immunosuppressive effects of disease and conjointly of therapy in MM, and response to vaccination to counter infection is compromised. The underlying factors in a weakened immune response in MGUS and MM are as yet not fully understood. A confounding factor is the onset of normal aging, which quantitatively and qualitatively hampers humoral immunity to affect response to infection and vaccination. In this review, we examine the status of immune alterations in MGUS and MM and set these against normal aging immune responses. We focus primarily on quantitative and functional aspects of B-cell immunity. Furthermore, we review the current knowledge relating to susceptibility to infectious disease in MGUS and MM, and how efficacy of conventional vaccination is affected by proliferative disease-related and therapy-related factors.

Keywords: MGUS, multiple myeloma, infections, immune defects, vaccination

Citation: Tete SM, Bijl M, Sahota SS and Bos NA (2014) Immune defects in the risk of infection and response to vaccination in monoclonal gammopathy of undetermined significance and multiple myeloma. Front. Immunol. 5:257. doi: 10.3389/fimmu.2014.00257

Received: 25 February 2014; Accepted: 18 May 2014;
Published online: 03 June 2014.

Edited by:

Harry W. Schroeder, University of Alabama at Birmingham, USA

Reviewed by:

Biao Zheng, Baylor College of Medicine, USA; University of Texas Medical School, USA
Stamatis-Nick Liossis, University of Patras Medical School, Greece

Copyright: © 2014 Tete, Bijl, Sahota and Bos. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Nicolaas A. Bos, Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen 9700 RB, Netherlands e-mail: n.a.bos@umcg.nl

Surinder S. Sahota and Nicolaas A. Bos – Joint Senior Authors.