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Has the Risk of Infection Shifted in the Era of Novel Multiple Myeloma Agents?

By: Julia Fiederlein Cipriano, MS
Posted: Wednesday, January 17, 2024

In the era of novel agents, infections still represent a threat to patients with multiple myeloma, according to Cecilie Hveding Blimark, PhD, MD, of Sahlgrenska University Hospital, Gothenburg, Sweden, and colleagues. The results of a population-based study were presented during the 2023 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 4696).

“[Patients with multiple myeloma had] an equally about fivefold increased risk for bacterial, viral, and fungal infections during the first year and up to 5 years after diagnosis, even in more recent years,” the investigators remarked. Using the Swedish Myeloma Registry, they identified 8,672 patients with symptomatic disease who were diagnosed between 2008 and 2021, along with 34,567 matched controls.

In addition, the risk of bacterial infection seemed to increase fourfold, whereas viral and fungal infections showed a sixfold increase. Specifically, patients with multiple myeloma appeared to have an increased risk of developing the following bacterial infections (P < .05): meningitis, septicemia, pneumonia, endocarditis, cellulitis, osteomyelitis, and pyelonephritis. In terms of viral infections, they demonstrated an increased risk for influenza and herpes zoster (both P < .05).

According to the investigators, compared with patients diagnosed between 2008 and 2012, those diagnosed between 2018 and 2021 had a slightly lower risk of infection (P < .05); the risk was slightly higher between 2013 and 2017 vs the first time period (P < .05). The cumulative risk of infection vs the controls was found to remain fivefold in patients diagnosed between 2008 and 2012 (P < .05) as well as 2013 and 2017 (P < .05), and it was fourfold (P < .05) in those diagnosed between 2018 and 2021. Females vs males appeared to experience a lower risk of infection (P < .001). Older age at diagnosis seemed to be associated with an increased risk of a first infection (P < .001).

Disclosure: For full disclosures of the study authors, visit

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