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Invasive Fungal Infections and Early Mortality in Patients With Multiple Myeloma

By: Susan Reckling
Posted: Wednesday, September 2, 2020

For patients with multiple myeloma, invasive fungal infections can increase their risk for early mortality. In an article in the Annals of Hematology, Chia-Jen Liu, MD, PhD, of the National Yang-Ming University, Taipei, and colleagues encouraged health-care professionals who care for patients with this type of hematologic malignancy to be aware of the risk factors—light chain disease, anemia, hypoalbuminemia, and receipt of allogeneic stem cell transplantation—for these rare but potentially deadly infections.

“To the best of our knowledge, this is, thus far, the largest study for invasive fungal infections in myeloma patients, in which invasive fungal infection diagnosis is confirmed by a thorough review of laboratory tests, microbiology data, and imagery,” the authors commented.

In this retrospective study, Dr. Liu and colleagues focused on 623 patients with multiple myeloma at Taipei Veterans General Hospital between January 2002 and October 2018. Of these patients, 22 (or 3.5%) were diagnosed with proven or probable invasive fungal infections, based on the European Organisation for Research and Treatment of Cancer/Mycoses Study Group criteria. All risk factors for these infections were estimated via Cox regression models in both univariate and multivariate analyses.

In the multivariate analysis, the following risk factors were significantly associated with invasive fungal infections: light chain disease (adjusted hazard ratio [HR] = 6.74; 95% confidence interval [CI] = 2.10–21.66), hemoglobin value less than 8 g/dL (adjusted HR = 3.34; 95% CI = 1.32–8.42), serum albumin level less than 3.5 g/dL (adjusted HR = 3.24; 95% CI = 1.09–9.68), and receipt of allogeneic stem cell transplantation (adjusted HR = 5.98; 95% CI = 1.62–22.03). In turn, contracting an invasive fungal infection was linked with early mortality (adjusted HR = 11.60; 95% CI = 1.26–106.74).

Disclosure: The study authors reported no conflicts of interest.

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