Posted: Friday, September 2, 2022
A prospective cohort study, led by Virginia Bove, MD, of Hospital Central de las Fuerzas Armadas, Montevideo, Uruguay, and colleagues, aimed to gain insight into the scope of infectious complications in patients with multiple myeloma residing in Latin America. More than 30% of patients experienced infections complications early on during their treatment, based on the results of this study, particularly in the first 3 months from diagnosis. Thus, clinicians should be encouraged to use antibiotic prophylaxis in this patient population. These findings were published in JCO Global Oncology.
“With a median follow-up of 6 months, the overall mortality rate was 8.5%, and almost half of these deaths were due to infections. This study confirms infections as a major cause of morbidity and early mortality in this patient population,” concluded the investigators.
This multicenter study enrolled 248 patients from seven Latin American countries; they all were newly diagnosed with multiple myeloma and on active therapy, with a follow-up of 6 months after diagnosis. Infectious events that required hospitalization for at least 24 hours were recorded.
Overall, 89 patients experienced a total of 113 infectious complication events, with most occurring within 3 months of diagnosis (67.3%). Respiratory (38%) and urinary (31%) tracts were the most frequent sites of infections, and Gram-negative bacteria (73.5%) were identified as the most common microbial agents responsible for infections in 57.5% of participants. Of note, there were no cases of fungal infection, and viral infections were not commonplace.
Treatment with immunomodulatory drugs (odds ratio [OR] = 3.02; P = .003), diabetes mellitus (OR = 2.71; P = .014), no trimethoprim/sulfamethoxazole prophylaxis (OR = 6.66; P < .001), and a creatinine level of 2 mg/dL or higher (OR = 4.87; P < .001) were independently associated with bacterial infections, according to multivariable analysis. Furthermore, 21 patients died at the 6-month mark; 47.6% of deaths were related to infectious complications.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.