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a weak immune system (caused by disease or by using certain medicine);
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Do not receive a "live" vaccine while using melphalan. The vaccine may not work as well during this time, and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

melphalan can pass into body fluids (urine, feces, vomit). Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

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Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

bone marrow suppression--sudden weakness or ill feeling, fever, chills, pale skin, easy bruising or bleeding, red or pink urine, painful mouth sores, cough, trouble breathing, feeling light-headed, rapid heart rate;
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