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Multiple Myeloma and Secondary Immunodeficiency: A Retrospective Database Analysis Assessing Burden of Infection and

Csaba Siffel1,2, Matthew S Davids3, Colin Anderson-Smits1

  • 1Global Evidence and Outcomes, Data and Quantitative Sciences Institute, Takeda Development Center Americas, Inc., Cambridge, Massachusetts, USA.

Advances in Hematology
|December 29, 2025
PubMed

Insights

Patients with multiple myeloma and secondary immunodeficiency face higher infection risks. Immunoglobulin replacement therapy may indicate a more vulnerable patient group, highlighting the need for better understanding of secondary immunodeficiency burden.

Area of Science:

  • Hematology
  • Immunology
  • Oncology

Background:

  • Multiple myeloma (MM) patients with secondary immunodeficiency (SID) are prone to infections.
  • Disease progression and treatment toxicity exacerbate infection risks in MM patients.

Purpose of the Study:

  • To assess the infection burden in MM patients with and without SID.
  • To compare outcomes between MM patients with SID receiving immunoglobulin replacement therapy (IgRT) versus those not receiving it.

Main Methods:

  • Retrospective cohort study using anonymized US claims data (October 2015-March 2020).
  • Patients aged ≥18 years with MM were classified into SID and no-SID cohorts based on IgG levels, diagnosis codes, and major infections.
  • SID patients were further stratified into IgRT and no-IgRT groups.

Main Results:

  • The SID cohort had significantly higher rates of infections (58.9% vs. 31.3%), severe infections (29.8% vs. 10.6%), and infection-related hospitalizations (26.9% vs. 9.1%) compared to the no-SID cohort.
  • Bacterial infections were most common, particularly in the SID cohort (49.2%) and IgRT subgroup (70.4%).
  • Overall survival was shorter in the SID cohort (12.6 months) versus the no-SID cohort (14.7 months).

Conclusions:

  • MM patients with SID experience a substantially higher burden of infection and poorer survival.
  • The increased infection rate in SID patients receiving IgRT suggests this subgroup represents a more vulnerable population.
  • Improved understanding and management of SID are crucial for enhancing outcomes in multiple myeloma patients.
Keywords:
databaseimmunoglobulin G replacement therapyinfections multiple myelomasecondary immunodeficiency

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