Related Experiment Video
Updated: Sep 26, 2025
An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
Published on: July 15, 2015
A simple score to predict early severe infections in patients with newly diagnosed multiple myeloma
Cristina Encinas1, José-Ángel Hernandez-Rivas2, Albert Oriol3
1Hospital General Universitario Gregorio Marañón (HGUGM), IiSGM, Madrid, Spain.
Abstract:
Infections remain a common complication in patients with multiple myeloma (MM) and are associated with morbidity and mortality. A risk score to predict the probability of early severe infection could help to identify the patients that would benefit from preventive measures. We undertook a post hoc analysis of infections in four clinical trials from the Spanish Myeloma Group, involving a total of 1347 patients (847 transplant candidates). Regarding the GEM2010 > 65 trial, antibiotic prophylaxis was mandatory, so we excluded it from the final analysis. The incidence of severe infection episodes within the first 6 months was 13.8%, and majority of the patients experiencing the first episode before 4 months (11.1%). 1.2% of patients died because of infections within the first 6 months (1% before 4 months). Variables associated with increased risk of severe infection in the first 4 months included serum albumin ≤30 g/L, ECOG > 1, male sex, and non-IgA type MM. A simple risk score with these variables facilitated the identification of three risk groups with different probabilities of severe infection within the first 4 months: low-risk (score 0-2) 8.2%; intermediate-risk (score 3) 19.2%; and high-risk (score 4) 28.3%. Patients with intermediate/high risk could be candidates for prophylactic antibiotic therapies.
Insights
A new risk score helps identify multiple myeloma patients at high risk for early severe infections. This score can guide preventive measures, potentially reducing infection-related morbidity and mortality in these vulnerable patients.
Area of Science:
- Hematology
- Oncology
- Infectious Diseases
Background:
- Infections are a major cause of morbidity and mortality in multiple myeloma (MM) patients.
- Predicting early severe infections is crucial for implementing timely preventive strategies.
Purpose of the Study:
- To develop and validate a risk score for predicting severe infections within the first 4 months of diagnosis in multiple myeloma patients.
- To identify patient subgroups that would benefit from prophylactic antibiotic therapies.
Main Methods:
- Post hoc analysis of infection data from four Spanish Myeloma Group clinical trials (1347 patients).
- Exclusion of one trial due to mandatory antibiotic prophylaxis.
- Development of a risk score based on variables associated with severe infection: low serum albumin, high ECOG performance status, male sex, and non-IgA myeloma type.
Main Results:
- The incidence of severe infections within 6 months was 13.8%, with 11.1% occurring within 4 months.
- 1.2% of patients died from infections within 6 months (1% within 4 months).
- The risk score identified three groups: low-risk (8.2%), intermediate-risk (19.2%), and high-risk (28.3%) for severe infections within 4 months.
Conclusions:
- A simple risk score incorporating serum albumin, ECOG status, sex, and myeloma type effectively stratifies multiple myeloma patients by early severe infection risk.
- Intermediate and high-risk patients identified by this score are potential candidates for prophylactic antibiotic treatment.
More Related Videos
07:53Interphase Fluorescence in situ Hybridization of Bone Marrow Smears of Multiple Myeloma
Published on: April 15, 2022
09:57Comprehensive Protocol to Sample and Process Bone Marrow for Measuring Measurable Residual Disease and Leukemic Stem Cells in Acute Myeloid Leukemia
Published on: March 5, 2018