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Published on: July 15, 2015
[Clinical and Immunological Features of Infectious Complications in Patients with Multiple Myeloma]
Background:
Infectious complications--the leading cause of mortality in patients with multiple myeloma (MM), their appearance is regarded as an adverse prognostic factor in the course of the disease.
Objective:
The aim of our study was to evaluate the clinical and immunological features of infectious complications in patients with G-immunochemical MM to find the most informative indicators in their forecasting.
Methods:
A randomized controlled trial was made. All patients were divided into 3 groupsfor comparison: Group 1 (n = 47)--MM patients, G-immunochemical variant with infection, Group 2 (n = 54)--MM patients, G-immunochemical option no infectious complications, and Group 3 (n = 125)--healthy volunteers. Research material was deoxygenated blood taken on admission of a patient to the hematology department before the pathogenetic treatment. Identification of G-variant was carried by immunofixation and electrophoresis. The immune status was assessed by indirect immunofluorescence. The concentration of IgA, M, E and G, and the levels of IL 2, IL 4, IL 8, TNFα, IFNγ in serum was determined by enzyme immunoassay. The activity of neutrophil granulocytes (NG) was studied by chemiluminescent analysis of spontaneous and induced production of reactive oxygen species. Statistical analysis was performed using the software STATISTICA v. 8.0 (USA), RESULTS: We analyzed data from 101 patients with MM and 125 healthy volunteers. The average age of MM patients was 60.53 ± 6.78 years. The group of healthy volunteers was similar in sex and age to groups of patients with MM. In patients with MM in the presence of infectious complications the researchers detected combined secondary development of T and B cell immunodeficiency, changes in non-specific immunity depended on the stage of the disease, unidirectional irregularities in spontaneous and induced chemiluminescence activity NG in II stage disease and multidirectional irregularities in stage III (p = 0.045). Prevalence of the content of proinflammatory cytokines on inflammatory (p < 0.001) and the deviation of the immune response to Th1-type were detected.
Conclusion:
the set of 6 informative indicators (the content of IL 4, IL 2, TNF α, IgG, the absolute number of CD4+ and CD19+ cells) enables the development of prediction method of infectious complications in patients with MM.
Insights
Infectious complications in multiple myeloma (MM) patients can be predicted using six key indicators: IL-4, IL-2, TNF-α, IgG levels, and CD4+ and CD19+ cell counts. This finding aids in developing a predictive method for these common complications.
Area of Science:
- Immunology
- Hematology
- Oncology
Background:
- Infectious complications are a primary cause of mortality in multiple myeloma (MM) patients.
- The occurrence of infections is considered an adverse prognostic factor in MM disease progression.
Purpose of the Study:
- To evaluate clinical and immunological features of infectious complications in G-immunochemical MM.
- To identify informative indicators for forecasting infectious complications in MM patients.
Main Methods:
- A randomized controlled trial compared MM patients with infections, MM patients without infections, and healthy volunteers.
- Immune status was assessed using immunofluorescence, serum cytokine levels (IL-2, IL-4, IL-8, TNF-α, IFN-γ) via ELISA, and neutrophil granulocyte activity by chemiluminescence.
- Statistical analysis was performed using STATISTICA v. 8.0.
Main Results:
- MM patients with infections exhibited secondary T and B cell immunodeficiency.
- Changes in non-specific immunity varied with disease stage, with specific irregularities in neutrophil granulocyte activity observed in stages II and III.
- Elevated pro-inflammatory cytokines and a shift towards a Th1-type immune response were detected.
Conclusions:
- A set of six indicators—IL-4, IL-2, TNF-α, IgG, CD4+ cells, and CD19+ cells—can be used to predict infectious complications in MM patients.
- These indicators enable the development of a predictive method for infectious complications in multiple myeloma.
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