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Multiple myeloma: infectious complications
K B Doughney1, D M Williams, R L Penn
1Hematology Unit, Strong Memorial Hospital, University of Rochester, NY.
Abstract:
We review a ten-year experience in treating 60 patients with multiple myeloma. Infectious episodes occurred in 33 patients. Urinary tract infections caused by gram-negative organisms were the most frequent infections, and most of these were the result of catheterization. Pneumonia due to Streptococcus pneumoniae was encountered infrequently. This series confirms the emergence of gram-negative bacilli as the predominant pathogens in patients with multiple myeloma, and emphasizes the risk of instrumentation in these patients.
Insights
Infections are common in multiple myeloma patients, with gram-negative bacteria, often from catheterization, being the most frequent. This study highlights the increased risk of infections associated with medical procedures in these individuals.
Area of Science:
- Hematology
- Infectious Diseases
- Oncology
Background:
- Multiple myeloma is a hematologic malignancy associated with immune dysfunction.
- Patients with multiple myeloma are susceptible to various infections.
- Understanding infection patterns is crucial for patient management.
Purpose of the Study:
- To review a decade of experience in treating multiple myeloma patients.
- To identify the types and sources of infectious episodes in this cohort.
- To assess the role of instrumentation in infection development.
Main Methods:
- Retrospective review of 60 multiple myeloma patients treated over ten years.
- Analysis of infectious episodes, pathogens, and potential risk factors.
- Categorization of infections based on site and causative organism.
Main Results:
- Infectious episodes occurred in 33 out of 60 patients.
- Urinary tract infections (UTIs) were the most frequent, predominantly caused by gram-negative organisms.
- Most gram-negative UTIs were associated with urinary catheterization.
- Pneumonia caused by Streptococcus pneumoniae was infrequent.
- Gram-negative bacilli emerged as the predominant pathogens.
Conclusions:
- Gram-negative bacilli are the leading infectious agents in multiple myeloma patients.
- Urinary tract infections, particularly those linked to catheterization, represent a significant risk.
- Minimizing instrumentation and implementing infection control measures are vital for this patient population.