Most folks over 40 walk around with Cytomegalovirus (CMV) and don't even know about it because it rarely causes problems in healthy people. CMV is related to the viruses that cause chickenpox, herpes simplex and mononucleosis. The virus is transmitted through bodily fluids (tears, saliva, etc.) but not by casual contact. Once infected, the virus stays in your body for life. CMV is a major cause for concern for those with a weakened immune system, as is the case with many multiple myeloma patients. The Mayo Clinic provides a nice summary of what CMV complications can occur in patients with a weakened immune system:
CMV infections occur in about 20% of patients undergoing allo-stem cell transplants (SCT). A recent article in the journal Annals of Internal Medicine provides hope to help us with the incidence rate of CMV after SCT. The article reports on the outcomes of a Phase II clinical study where patients at risk for CMV infections were given a new vaccine after transplant (intramuscular injection on days 28 and 56). The official, scientific name of this vaccine is "modified vaccinia Ankara, engineered to induce a robust and durable virus-specific T cell response to three immuno-dominant proteins linked to CMV complications in stem cell transplant recipients." The vaccine is also called the Triplex vaccine. The study enrolled a total of 102 patients, half of whom were given the vaccine and half who were given a placebo injection. The results are impressive:
There is currently a supplemental trial underway at City of Hope in Los Angeles. The trial:
"vaccinates the patient's donor with Triplex. That could provide the patient with earlier and greater immunity against CMV, which is particularly important for patients undergoing high-risk transplants in which they have a haploidentical donor (a half-matched bone marrow donor.)"
The study in question is a relatively small study. Before we will see this vaccine in clinical practice it will still need to complete a larger Phase III study and then go through FDA/regulatory review. I am hopeful, however, that FDA will designate this vaccine as a 'breakthrough medicine', meaning that the Biologics License Application will be fast-tracked through the Agency and that we may see this vaccine in routine use in a relatively short period of time (hopefully, a few years).
about the author
I am a patient diagnosed in 2014 with primary plasma cell leukemia (pPCL), a rare and aggressive variant of multiple myeloma and have been very fortunate to find successful treatment at the division of Cellular Therapy at the Duke University Cancer Institute. My wife, Vicki, and I have two adult children and two grandsons who are the ‘lights of our lives’. Successful treatment has allowed Vicki and I to do what we love best : traveling the world, albeit it with some extra precautions to keep infections away. My career in the pharmaceutical industry has given me insights that I am currently putting to use as an advocate to lower drug pricing, especially prices for anti-cancer drugs. I am a firm believer that staying mentally active, physically fit, compliant to our treatment regimen and taking an active interest in our disease are keys to successful treatment outcomes.