Depends. Some people have their immunity get to normal levels. Some people don't. Many myeloma patients have a very low immunity to start with. After all, its a cancer of plasma cells that make antibodies to help protect us from infection. My immunoglobulins have been very low since diagnosis and the treatment makes them lower. This is why some people with myeloma need Gammguard if they continue to get serious infections. We need to remain vigilant about protecting outselves from infections. Masking, vaccines, Evusheld, shingles prevention etc. Knowing your immunoglobulin levels is very important. Love Donna 💗

Jeanette. I had my SCT in April of 2018. I thankfully have been in full remission since February that same year. At two years post-SCT (when the Covid concerns started), I asked that same question of my transplant Dr. and also my Oncologist. They both considered my new immune system to be very strong but "it didn't really know what was doing yet". Even though I re-did all of my childhood vaccinations they worry that something might come along and be a problem. I'm sure this concern lessens over time, however I would would imagine that even a low dose of Revlimid (I'm on 5mg. for maintenance) does somewhat weaken your overall immune system. I always have slightly low platelets while on Revlimid.
Hope this helps, but I would always run these questions by your oncologist.

Ask do tor for sure. My doctor is having me get all of my vacations redone. It takes about 27 months.

Hi Jeanette2

I can't speak to the SCT specifically but if you stay on Maintenance Meds forever than Yes, you'll continue to be immune compromised (please confirm with your doc). My doc told me the MM Meds will continue to keep my Ig levels much lower than normal. As such, this makes a person immune compromised.

I did not ask and its worth knowing if the lower levels of maintenance would eventually allow the Ig levels to return to normal. I was on low maintenance since early Feb. - all of my Ig levels remained low. Now as of late June, I'm off all MM meds. My next Labs is early Aug. I'm hoping to see some improvement but it may be too soon.

Do an google search for MRD-SURE. It references a 2022 study of getting to MRD 0 - (10 -6) based on the clonoSEQ testing method, that if achieved (with or without a SCT - Negative is Negative) its reasonable to do observation without Any continued maintenance meds. In this case, a person should be able to have their immune system return to normal.

Since I've only read this study, its a topic I'll be discussing with both my doctors to see if my immune system will return on its own (without continuing meds) or if I'll need Ig shots or a transfusion. My expectation is it will occur naturally. In a related issue, my JH doc said to me that now that I'm off MM Meds and MRD 0, my osteoclast and osteoblast will return to their normal function of bone regeneration. But he also said that if I continued with Xgeva, it would disrupt the osteo functions.

All the Best,
Larry2

That's a great question for you to ask your oncologist. He/she should be able to answer you. Jack