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, no studies have explored the spectrum and risk factors of infections in newly diagnosed MM patients at the first admission. This cross-sectional study aimed to provide ideas for the assessment, prevention and treatment of infection in newly diagnosed MM patients when admitted for the first time. Methods: Retrospectively, the data from electronic medical records for 161 patients newly diagnosed with MM from May 2013 to December 2018 were analysed. All the information was collected at the time of admission, and the patients had received no antineoplastic therapy previously. 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 Epstein-Barr virus (EBV) (24.4%) and hepatitis B virus (HBV) (17.1%). Advanced stage (ISS stage III, P =0.040), more severe anaemia (Hb<90 g/L, P =0.044) and elevated CRP (>10 mg/L, P =0.006) were independent risk factors for infection. Moreover, infections represented a major survival threat to patients with newly diagnosed MM ( P = 0.033), and the existence of risk factors for infection was significantly correlated with poor prognosis ( P = 0.011), especially ISS stage III ( P =0.008) and lower haemoglobin level ( P =0.039). Conclusions: Newly diagnosed MM patients are highly susceptible to viruses. Advanced ISS stage, more severe anaemia and the elevation of CRP are independent risk factors of infection, which also have a strong impact on prognosis. Our results suggest that 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 in newly diagnosed patents with advanced stage and more severe anaemia.

Spurious laboratory results associated with immunoglobulin M gammopathy in a dog with multiple myeloma

“…The neutrophilic stomatitis was considered most likely secondary to multiple myeloma and the increased susceptibility to infection commonly seen in these animals. 23 The heart-base mass was considered most likely an unrelated comorbidity, and further investigation of this was declined by the owner because of procedure-associated risks.…”

“…Given the lack of travel history, low incidence of vector‐borne disease in the UK, and negative subsequent infectious disease testing, concurrent borreliosis, anaplasmosis, or leishmaniasis was considered unlikely and false‐positive results secondary to paraprotein interference were suspected. The neutrophilic stomatitis was considered most likely secondary to multiple myeloma and the increased susceptibility to infection commonly seen in these animals 23 . The heart‐base mass was considered most likely an unrelated comorbidity, and further investigation of this was declined by the owner because of procedure‐associated risks.…”