Inflammation and infection in plasma cell disorders: how pathogens shape the fate of patients

Area of Science:

• Hematology
• Immunology
• Oncology

Background:

• Infection is a frequent complication and leading cause of death in plasma cell disorders (PCD).
• The increasing use of immunotherapies in multiple myeloma necessitates understanding infection risks and prevention.
• Pathogens and chronic inflammation are increasingly recognized for their role in PCD initiation, progression, and treatment response.

Purpose of the Study:

• To review factors contributing to high infectious risk in PCD.
• To highlight current and future prophylactic and preventive strategies for infections in PCD patients.
• To explore the direct and indirect roles of pathogens in PCD biology, including the microbiome's influence.

Main Methods:

• Literature review of existing studies on infection in PCD.
• Analysis of factors contributing to infectious risk (disease status, age, comorbidities, treatment).
• Discussion of the interplay between pathogens, inflammation, and immune response in PCD.

Main Results:

• Multiple factors, including disease status, patient demographics, comorbidities, and treatments, contribute to infectious risk in PCD.
• Immune-based therapies can alter infection epidemiology in multiple myeloma.
• Pathogens may directly and indirectly influence PCD initiation, progression, and response to therapy.

Conclusions:

• Recognizing and mitigating infectious risks is crucial for improving outcomes in PCD.
• Prophylactic and preventive strategies are needed to manage the high burden of infection in PCD.
• Further research, including large-scale studies, is required to elucidate the precise role of pathogens and the microbiome in PCD natural history and biology.