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Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Posted: Tuesday, July 5, 2022
Infections remain a common complication in patients with multiple myeloma; thus, Cristina Encinas, MD, of the Hospital General Universitario Gregorio Marañón, Madrid, and colleagues developed a risk score to predict the probability of early severe infection in newly diagnosed patients with this hematologic malignancy. Their findings, which were published in the Blood Cancer Journal, demonstrate a potential way to identify patients who may benefit from preventive measures.
“Our study confirms that a high proportion of serious infections occur within the first 4 months,” the investigators commented. “When the intermediate- and high-risk were grouped, the differences persist, so patients at intermediate or high risk are the ideal candidates to be treated with prophylactic antibiotics, although this should be validated in independent cohort studies.”
Using data from four clinical trials conducted by the Spanish Myeloma Group (GEM2005 > 65, GEM2010 > 65, GEM2005 < 65, and GEM2012 < 65), the investigators focused on 1,347 patients with newly diagnosed disease; of this population, 847 were candidates for transplantation. Due to the administration of antibiotic prophylaxis, patients enrolled in the GEM2010 > 65 trial (n = 241) were excluded from the risk score final analysis (n = 1,106). The incidence of episodes of severe infection within the first 6 months was 13.8%; a total of 11.1% of patients experienced the first episode before 4 months. Infections led to death in 1.0% and 1.2% of patients within the first 4 and 6 months, respectively.
Serum albumin levels of up to 30 g/L, Eastern Cooperative Oncology Group performance status scores greater than 1, male sex, and non–immunoglobulin A–type multiple myeloma seemed to be associated with an increased risk of severe infection within the first 4 months. Using these variables, the investigators identified three risk groups with different probabilities of severe infection within the first 4 months: 8.2% with low risk (score = 0–2), 19.2% with intermediate risk (score = 3), and 28.3% with high risk (score = 4).
Disclosure: The study authors reported no conflicts of interest.
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