Do you recommend vaccinations in patients with hematologic malignancies?
Mark Crowther: No, I do not, and I do not think it is generally recommended for a couple of reasons. [Patients with hematologic malignancies] should obviously get the vaccinations that are required, so they should get their annual flu vaccination. If they have not had their Pneumovax, they should get that.
We do not recommend specific additional vaccinations in people who have hematologic malignancies for a couple reasons. One is there is no evidence that they improve the patient’s outcome, but more importantly, if they have got a high-grade malignancy, they are going to have an impaired immune response. There is little rationale, I think, to assuming that there is going to be a beneficial effect. Vaccines as required for any person, yes, but not anything special for patients who have hematologic malignancies.