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Post-Transplant Infections in Multiple Myeloma and Lymphoma: Early Vulnerabilities and Long-Term Risks in ASCT
Muchlis Achsan Udji Sofro1, Mila Astrilia2, Galih Prakasa Adhyatma3
1Infectious Diseases and Tropical Infection Division, Department of Internal Medicine, Faculty of Medicine, Diponegoro University, RSUP Dr. Kariadi Semarang, Indonesia.
Background:
Patients with multiple myeloma (MM) and lymphoma undergoing autologous stem cell transplantation (ASCT) are at a higher risk of infection leading to increased morbidity and mortality. This study aims to analyze the infection patterns and outcomes in this population.
Methods:
A retrospective, descriptive study was conducted at Dr. Kariadi General Hospital, Semarang, Indonesia, involving 28 patients diagnosed with MM and lymphoma who underwent ASCT from January 2013 to May 2023. Data were collected from medical records and phone interviews. Infection patterns, bacterial pathogens, and outcomes were analyzed.
Results:
Of the 28 patients, 75% experienced post-ASCT infections. Infections occurred predominantly in the first 10 days post-transplant, with 85% of infections occurring during this period. Six patients experienced multiple infection episodes. Blood cultures revealed 52% Gram-positive and 29% Gram-negative bacterial infections. Three patients (14%) died within 28 days post-transplant, though these deaths were attributed to non-infectious causes, including pulmonary edema and hemorrhagic stroke. Two patients developed late-onset infections occuring more than 300 days post-transplant.
Conclusions:
Infections remain a significant complication following ASCT in MM and lymphoma patients, particularly within the early post-transplant period. Gram-positive bacteria, especially Staphylococcus species, were the predominant pathogens identified.
Insights
Infections are common after autologous stem cell transplantation (ASCT) for multiple myeloma and lymphoma. Early post-transplant infections, often Gram-positive bacterial, pose significant risks.
Area of Science:
- Hematology
- Infectious Diseases
- Oncology
Background:
- Autologous stem cell transplantation (ASCT) is a critical treatment for multiple myeloma (MM) and lymphoma.
- Patients undergoing ASCT face heightened risks of infection, morbidity, and mortality.
- Understanding infection patterns post-ASCT is vital for improving patient outcomes.
Purpose of the Study:
- To analyze infection patterns and outcomes in MM and lymphoma patients post-ASCT.
- To identify common pathogens and the timing of infections.
Main Methods:
- Retrospective descriptive study.
- Involved 28 patients with MM and lymphoma undergoing ASCT (January 2013 - May 2023).
- Data collected from medical records and phone interviews; infection patterns, pathogens, and outcomes analyzed.
Main Results:
- 75% of patients experienced post-ASCT infections, predominantly within the first 10 days (85%).
- Gram-positive bacteria (52%) were more common than Gram-negative (29%) in blood cultures.
- Three non-infectious deaths occurred; two late-onset infections were noted.
Conclusions:
- Infections are a significant complication after ASCT for MM and lymphoma.
- Early post-transplant infections are most common.
- Gram-positive bacteria, particularly Staphylococcus species, are the predominant pathogens.
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