Assessment of infection in newly diagnosed multiple myeloma patients: Risk factors and main characteristics

Abstract

Background: Infection is a leading cause of morbidity and death in patients with multiple myeloma (MM). The increased susceptibility to infection is complicated and multifactorial. However, none of the studies had assessed the risk of infection in MM patients who didn’t receive the antitumor treatment. For the first time, this study aimed to provide ideas for the assessment, prevention and treatment of infection in newly diagnosed MM patients without antitumor therapy. Methods: Retrospectively, the data from electronic medical records for 161 cases of hospitalized patients with multiple myeloma were analyzed, during May 2013 to December 2018. Independent risk factors of infection in multiple myeloma were determined by univariate and multivariate analysis. Results: Newly diagnosed patients with MM were highly susceptible to viruses (43.9%), especially the EBV (24.4%) and HBV (17.1%). More advanced stage (ISS-Ⅲ stag, P=0.040), more severe anemia (Hb<90 g/L, P=0.044) and the elevation of CRP (>10 mg/L, P=0.006) were the independent risk factors of infection. Moreover, infections represented a major threat to patients with newly diagnosed MM (P = 0.033), and the existence of risk factors for infection was significantly related to poor prognosis (P = 0.011), especially the ISS-Ⅲ stage (P=0.008) and lower hemoglobin level (P=0.039). Conclusions: MM patients without antitumor therapy are highly susceptible to viruses. Advanced ISS stage, more severe anemia and the elevation of CRP were identified as independent risk factors of infection, which also have a strong impact on the prognosis. Our results suggest that the viral infection should be taken into account if antibacterial drugs are not effective, and the prevention of infection and improvement of prognosis should be paid more attention to in the newly diagnosed patents with more advanced stage and more severe anemia.