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

Lin, Chenyao; Shen, Hui; Zhou, Shuimei; Liu, Minghui; Xu, Anjie; Huang, Shuang; Shen, Changqing; Zhou, Fuling

doi:10.21203/rs.2.12346/v2

Cited by 1 publication

(1 citation statement)

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“…The criteria for infection in this study were defined as the existence of a pathogen and imaging evidence of infection combined with concomitant clinical symptoms, such as non-pharmacological rise in body temperature (> 37 °C), cough with sputum, and painful urination. Bacteria and fungi were identified by morphological, biochemical, and serological reactions after isolation, purification, and cultivation [17]. Early infection was deemed as that occurring during the first 4 months of treatment [5].…”

Section: Study Endpointsmentioning

confidence: 99%

Long-acting granulocyte colony-stimulating factor in primary prophylaxis of early infection in patients with newly diagnosed multiple myeloma

Ding

Gu³

et al. 2022

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Purpose This study sought to compare the efficacy of prophylactic long-acting and standard granulocyte colony-stimulating factor (G-CSF) on febrile neutropenia, early infections, and treatment delay in patients with newly diagnosed multiple myeloma (MM) receiving the therapeutic regimen of bortezomib, lenalidomide, and dexamethasone (VRd). Methods A prospective study with 68 consecutive patients with MM was conducted in three regional hospitals. Participants were randomly treated with the VRd regimen in combination with prophylactic long-acting G-CSF (treatment group) or prophylactic standard G-CSF (control group). The primary endpoints were the incidence rates of febrile neutropenia, early infection, and treatment delays. The secondary endpoint was clinical outcomes. Results Thirty-three patients were assigned to the treatment group, and thirty-five patients were assigned to the control group. The incidence of febrile neutropenia was 6.1% and 17.1% in the treatment and control groups, respectively (p = 0.297). However, the rates of early infection and treatment delay were markedly lower in the treatment group than in the control group (6.1% vs. 25.7% and 9.1% vs. 31.4%; p < 0.05). Notably, all early infections occurred during the first four cycles of VRd therapy, and the most common type of infection was pneumonia. No significant difference in clinical efficacy was found between the two groups. All participants achieved at least partial remission. Conclusions Prophylactic administration of domestic long-acting G-CSF markedly reduced the rates of early infection and treatment delay as compared with standard G-CSF in patients newly diagnosed with MM. Notably, all early infections occurred during the first four cycles of VRd therapy. As such, it seems appropriate to administer long-acting G-CSF with the aim of primary prophylaxis of early infection in the setting of newly diagnosed MM.

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Section: Study Endpointsmentioning

confidence: 99%