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Cytomegalovirus reactivation in patients with multiple myeloma

Tetsuo Hasegawa1, Yoshinobu Aisa1, Kengo Shimazaki1

  • 1Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.

European Journal of Haematology
|March 27, 2015
PubMed

Insights

Novel agents for multiple myeloma (MM) increase cytomegalovirus (CMV) reactivation risk. Monitoring elderly MM patients, especially those with extramedullary disease, is crucial for timely diagnosis and treatment.

Area of Science:

  • Oncology
  • Infectious Diseases
  • Virology

Background:

  • Novel antimyeloma agents have significantly improved multiple myeloma (MM) outcomes.
  • These advancements are associated with an increased incidence of Herpesviridae infections, particularly cytomegalovirus (CMV) reactivation.

Purpose of the Study:

  • To retrospectively assess the incidence and risk factors of CMV reactivation in newly diagnosed multiple myeloma patients treated with novel agents.
  • To compare clinical and laboratory characteristics between CMV-reactivation positive and negative patients.

Main Methods:

  • Retrospective analysis of 120 newly diagnosed MM patients.
  • CMV antigenemia testing performed in 58 patients based on clinical context.
  • Comparison of clinical and laboratory data between CMV-positive and CMV-negative groups.

Main Results:

  • CMV reactivation occurred in 20% (24/120) of patients, with 11% (13/120) developing CMV disease requiring antiviral therapy.
  • Patients with extramedullary disease or low absolute lymphocyte count (ALC) showed a higher risk of CMV reactivation.
  • Median time from MM diagnosis to CMV reactivation was 5.0 months.

Conclusions:

  • CMV reactivation is a significant concern in MM patients treated with novel agents, irrespective of stem cell transplantation (SCT).
  • Elderly MM patients, particularly those with extramedullary disease, require vigilant monitoring for CMV reactivation.
  • Timely diagnosis and treatment of CMV reactivation are essential for managing these patients.
Keywords:
cytomegalovirusmultiple myelomareactivation

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