Reduced risk of bacterial infection in multiple myeloma patients with VAD regimen without intermittent high-dose dexamethasone

Isoda, Atsushi; Matsumoto, Morio; Nakahashi, Hirotaka; Mawatari, Momoko; Manaka, Akihiro; Sawamura, Morio

doi:10.1007/s12185-010-0735-1

Cited by 7 publications

(6 citation statements)

References 26 publications

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“…No difference in infection rate was found between different ISS groups of patients, but advanced Durie-Salmon Stage IIIB 3B was significantly associated with more frequent infective complications. Contrary to some other studies [ 43 , 44 ], this result supports the idea that large tumour burden, especially when associated with renal failure, is an important infection risk factor in myeloma patients [ 43 , 44 ]. Like in other groups, a positive correlation between renal dysfunction and infections was found and these patients had a significantly higher rate of infective complications [ 10 , 43 , 45 , 46 , 47 , 48 , 49 ], which should be included in the estimation of infection risk [ 10 , 43 , 45 , 46 , 47 , 48 , 49 ].…”

Section: Discussionsupporting

confidence: 83%

Infections in Hospitalised Patients with Multiple Myeloma: Main Characteristics and Risk Factors

Valković¹,

Gačić²,

Ivandic³

et al. 2015

Tjh

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Objective:Multiple myeloma is a common haematological malignancy and immune dysfunction is the hallmark of the disease. It leads to an increased infection risk, which is still a major cause of mortality. The infection spectrum and characteristics have evolved with the introduction of novel agents. An understanding of risk factors that increase susceptibility to infections is critical in fighting them. This retrospective investigation aimed to establish the incidence and main characteristics of infections in non-transplanted hospitalised myeloma patients in our department over a 3-year period, as well as factors associated with infections.Materials and Methods:A total of 240 hospitalised patients with multiple myeloma (120 males and 120 females; average age: 69 years, range: 41-89 years) who were diagnosed or treated in our department from January 2008 to December 2010 were included in this study and their data were retrospectively analysed.Results:Infections were identified in 17.9% of hospitalised patients. The most common pathogen found was Pseudomonas aeruginosa. The frequency of gram-positive and gram-negative pathogens was similar. In 37.2% of cases, the agent was not isolated. The most common sites of infections were the urinary system and the blood (septicemia). The frequency of infection increased with duration of disease and the rate of reinfection was 41.9%. The patients treated with bortezomib had the highest infection occurrence. Fatal outcome occurred in 9.3% of cases.Conclusion:The factors associated with infections in this investigation were female sex, 3B clinical stage of disease, increased serum creatinine and ferritin levels, neutropenia, poor general condition, and presence of catheters. Myeloma patients with one or more of these mentioned risk factors should be monitored with particular care in order to decrease the incidence and severity of infective complications.

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Section: Discussionsupporting

confidence: 83%

Infections in Hospitalised Patients with Multiple Myeloma: Main Characteristics and Risk Factors

Valković¹,

Gačić²,

Ivandic³

et al. 2015

Tjh

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“…In an unselected cohort, Caravita et al [ 45 ] reported that only ISS stage was a risk factor affecting severe infection development. Isoda et al [ 46 ] indicated that advanced ISS stage was an independent risk factor associated with severe (grade C 3) bacterial infection in MM patients. A large number of studies [ 13 , 26 , 33 ] have shown that advanced ISS stage is an important risk factor for infection in MM patients.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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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.

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“…In an unselected cohort, Caravita et al [45] reported that only ISS stage was a risk factor affecting severe infection development. Isoda et al [46] indicated that advanced ISS stage was an independent risk factor associated with severe (grade C 3) bacterial infection in MM patients. A large number of studies [13,26,33] have shown that advanced ISS stage is an important risk factor for infection in MM patients.…”

Section: Discussionmentioning

confidence: 99%

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

Lin

Shen

Zhou

et al. 2019

Preprint

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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.

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Reduced risk of bacterial infection in multiple myeloma patients with VAD regimen without intermittent high-dose dexamethasone

Cited by 7 publications

References 26 publications

Infections in Hospitalised Patients with Multiple Myeloma: Main Characteristics and Risk Factors

Infections in Hospitalised Patients with Multiple Myeloma: Main Characteristics and Risk Factors

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

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

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