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Published on: February 14, 2011
Case Report: Invasive Fungal Infection and Daratumumab: A Case Series and Review of Literature
Francesca Farina1, V Ferla1, S Marktel1
1Hematology and Bone Marrow Transplantation, San Raffaele Scientific Institute, Milan, Italy.
Abstract:
Life expectancy of multiple myeloma (MM) patients has improved in last years due to the advent of anti-CD38 monoclonal antibodies in combination with immunomodulators and proteasome inhibitors. However, morbidity and mortality related to infections remain high and represent a major concern. This paper describes the "real life" risk of invasive fungal infections (IFI) in patients treated with daratumumab-based therapy and reviews the relevant literature. In a series of 75 patients we only observed three cases of fungal pneumonia. Unfortunately, the early signs and symptoms were not specific for fungal infection. Diagnostic imaging, microbiology and patient history, especially previous therapies, are critical in the decision to start antifungal treatment. Recognising the subgroup of MM patients with high risk of IFI can increase the rate of diagnosis, adequate treatment and MM-treatment recovery.
Insights
While new multiple myeloma (MM) therapies improve survival, invasive fungal infections (IFI) remain a risk. This study found a low rate of IFI in patients receiving daratumumab-based therapy, emphasizing early diagnosis and risk assessment.
Area of Science:
- Oncology
- Infectious Diseases
- Pharmacology
Background:
- Multiple myeloma (MM) treatments have advanced, improving patient life expectancy.
- Despite treatment progress, infections, particularly invasive fungal infections (IFI), pose significant morbidity and mortality risks for MM patients.
- Daratumumab-based therapies are increasingly used for MM, necessitating an understanding of their associated infection risks.
Observation:
- This study evaluated the real-world incidence of IFI in 75 patients undergoing daratumumab-based therapy for multiple myeloma.
- Only three cases of fungal pneumonia were observed, suggesting a potentially lower risk than anticipated.
Findings:
- Early signs of fungal infection in MM patients are often non-specific.
- Diagnostic tools including imaging, microbiology, and patient history are crucial for timely diagnosis and initiation of antifungal treatment.
- Identifying high-risk MM patient subgroups is essential for proactive management of IFI.
Implications:
- Early recognition and prompt antifungal treatment can improve outcomes for MM patients.
- Understanding IFI risk in the context of novel therapies like daratumumab is vital for clinical practice.
- Further research into specific risk factors and diagnostic biomarkers for IFI in MM patients is warranted.
