Unmasking Infection Risks in Multiple Myeloma: Insights from a Retrospective Analysis

• Published in: Indian journal of hematology & blood transfusion 2024-10, Vol.40 (4), p.588-595
• Main Authors: Jacob, Linu Abraham, Choudhary, Sabeena K., Babu, M. C. Suresh, K N, Lokesh, Rudresha, A. H., Rajeev, L. K., Saldanha, Smitha C., Hegde, Anup, B M, Vivek
• Format: Article
• Language: English
• Subjects: Bacteria; Blood Transfusion Medicine; Gram-positive bacteria; Hematology; Human Genetics; Infections; Medicine; Medicine & Public Health; Mortality; Multiple myeloma; Oncology; Original Article; Pathogens
• ISSN: 0971-4502; 0974-0449; 0974-0449; 0971-4502
• DOI: 10.1007/s12288-024-01753-7

Multiple myeloma (MM) has witnessed significant therapeutic advancements through the introduction of proteasome inhibitors and immunomodulators, leading to improved treatment outcomes. However, infections remain a formidable challenge for MM patients. The objective of our research is to investigate the factors that can forecast infection risk in MM patients. In pursuit of this, we conducted a thorough retrospective examination of medical records from Kidwai Memorial Institute of Oncology, Bangalore, involving 145 MM patients. Out of the 145 patients analyzed, almost half (47.5%; n  = 69) encountered at least one infection during the course of their disease. Respiratory-related infections were the most prevalent (76.2%), followed by urinary tract infections (10%) and instances of diarrhea (8.8%). Notably, gram-positive bacteria constituted the majority of identified causative organisms, accounting for 48.2% of isolated pathogens, while gram-negative bacteria comprised 37.9% of the isolated organisms. Most infections were observed either at the time of presentation or during the first month (40.5%). Overall mortality during the study period was 4.8% ( n  = 7). Infections contributed to 57.1% ( n  = 4 out of 7 deaths) of the mortality. Moreover, patients in advanced stages exhibited an elevated risk of infection at presentation. Infections remain a major cause of morbidity and mortality in patients with MM. Nearly half of MM patients experience an episode of infection during treatment.Gram-positive bacteria are the most common pathogens, with respiratory infections being the most common foci. Prompt identification and treatment of infections is essential, but can be challenging due to atypical or absent symptoms. Antibacterial prophylaxis is an important preventive strategy, but further research is needed to develop innovative approaches to infection prevention and targeted therapeutic interventions. We must strive to develop innovative approaches to infection prevention in MM patients. Also we need to advance our understanding of the interplay between infections and MM to improve quality of care and outcomes for these individuals. By addressing these challenges, we can aspire to offer MM patients a brighter and healthier future.