Zhongguo shi yan xue ye xue za zhi · 2024
[Clinical Characteristics and Risk Factors of Infection in Hospitalized Patients with Multiple Myeloma with New Generation Therapies].
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Yang Li-Ping, Lu Xin-Yi, Wang Xin-Wei, Yao Qiong, Li Lin-Yu, Zhao Jie, He Shao-Long, Tian Wei-Wei
Аннотация
OBJECTIVE: To evaluate the clinical characteristics and risk factors of infections occurring during hospitalization in patients with multiple myeloma(MM) treated with new generation therapies (including immuno- modulatory drugs, proteasome inhibitors and monoclonal antibodies).
METHODS: The clinical data were collected from 155 patients with multiple myeloma who were treated in Shanxi Bethune Hospital from March, 2017 to March, 2022 and were retrospectively analyzed. For this study, the following therapies were considered to be new generation therapies: lenalidomide, pomadomide, bortezomib, ixazomib, daratumumab. The clinical characteristics and risk factors of infection were analyzed.
RESULTS: A total of 155 patients were included in this study. The median follow-up time was 20 months. Of 155 patients with MM, 242 infection episodes were identified. Among the 242 infections, the incidence of clinically defined infection (CDI) was the highest (186, 76.86%), followed by microbiologically defined infection (MDI) in 50 cases (20.66%), and fever at unknown focus (FUF) in 6 cases (2.48%). 35 cases (14.46%) of bacteria, 10 cases (4.13%) of viruses, and 5 cases (2.07%) of fungi were clearly infected. The most common site of infection was the lower respiratory tract in 90 cases (37.19%), the upper respiratory tract in 83 cases (34.30%), and the digestive tract in 27 cases (11.16%). All-cause mortality was 8.39%(13/155). In univariate analysis, there was a higher correlation between ISS stage III, the number of treatment lines ≥2, frail and infected patients with multiple myeloma. In multivariate analysis, ISS stage III（OR =2.96， 95%CI ： 1.19-7.40， P =0.02), the number of treatment lines ≥2 （OR =2.91， 95%CI ： 1.13-7.51， P =0.03） and frail （OR =3.58， 95%CI ： 1.44-8.89， P =0.01）were risk factors for infection in patients with multiple myeloma in the era of new drugs.
CONCLUSION: Patients with multiple myeloma treated with new agents are prone to bacterial infection during hospitalization. ISS stage III, lines of therapy（≥2） and frail were associated with high risk for infection.
METHODS: The clinical data were collected from 155 patients with multiple myeloma who were treated in Shanxi Bethune Hospital from March, 2017 to March, 2022 and were retrospectively analyzed. For this study, the following therapies were considered to be new generation therapies: lenalidomide, pomadomide, bortezomib, ixazomib, daratumumab. The clinical characteristics and risk factors of infection were analyzed.
RESULTS: A total of 155 patients were included in this study. The median follow-up time was 20 months. Of 155 patients with MM, 242 infection episodes were identified. Among the 242 infections, the incidence of clinically defined infection (CDI) was the highest (186, 76.86%), followed by microbiologically defined infection (MDI) in 50 cases (20.66%), and fever at unknown focus (FUF) in 6 cases (2.48%). 35 cases (14.46%) of bacteria, 10 cases (4.13%) of viruses, and 5 cases (2.07%) of fungi were clearly infected. The most common site of infection was the lower respiratory tract in 90 cases (37.19%), the upper respiratory tract in 83 cases (34.30%), and the digestive tract in 27 cases (11.16%). All-cause mortality was 8.39%(13/155). In univariate analysis, there was a higher correlation between ISS stage III, the number of treatment lines ≥2, frail and infected patients with multiple myeloma. In multivariate analysis, ISS stage III（OR =2.96， 95%CI ： 1.19-7.40， P =0.02), the number of treatment lines ≥2 （OR =2.91， 95%CI ： 1.13-7.51， P =0.03） and frail （OR =3.58， 95%CI ： 1.44-8.89， P =0.01）were risk factors for infection in patients with multiple myeloma in the era of new drugs.
CONCLUSION: Patients with multiple myeloma treated with new agents are prone to bacterial infection during hospitalization. ISS stage III, lines of therapy（≥2） and frail were associated with high risk for infection.