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Clinical problems of infectious complications in patients with multiple myeloma
1Clinic of Haematology, University of Medicine, Plovdiv, Bulgaria.
Abstract:
Infectious complications in 126 patients with multiple myeloma were studied throughout the entire course of the disease. Various infectious complications were found in 71 patients (56.3%). They had predominantly pulmonary (42%) and renal (37%) localisation. Most commonly, they were manifested in the acute stages of the myelomatosis: the onset of the disease, during and after the induction therapy, the relapses and in the terminal stage. Using various biologic, clinical, immunologic, biochemical, therapeutic and prognostic criteria all patients presenting with infectious complications were compared with the rest of the patients. Statistically significant risk factors for an infectious process were shown to be old age, the disease in its third clinical stage, light chain myelomas, secretion of lamda light chains, leucopenia, azotaemia, polyclonal suppression of immunoglobulins and inadequate therapeutic response. The infection complications do not have significant impact on the survival of myeloma patients.
Insights
Infectious complications, primarily pulmonary and renal, affect over half of multiple myeloma patients. Risk factors include advanced disease and immune suppression, but infections do not significantly impact survival.
Area of Science:
- Hematology
- Oncology
- Infectious Diseases
Background:
- Multiple myeloma is a hematologic malignancy associated with immune dysfunction.
- Infectious complications are a significant concern for patients with multiple myeloma.
- Understanding the patterns and risk factors of infections is crucial for patient management.
Purpose of the Study:
- To investigate the incidence, localization, and timing of infectious complications in multiple myeloma patients.
- To identify risk factors associated with infectious processes in this patient population.
- To assess the impact of infectious complications on the survival of multiple myeloma patients.
Main Methods:
- Retrospective analysis of 126 multiple myeloma patients.
- Detailed review of infectious complications throughout the disease course.
- Comparison of patients with and without infectious complications using clinical, biological, and prognostic criteria.
Main Results:
- Infectious complications occurred in 56.3% of patients, predominantly affecting the lungs (42%) and kidneys (37%).
- Infections were most common during acute disease phases, including onset, therapy, relapses, and terminal stages.
- Significant risk factors included older age, advanced disease stage, light chain myeloma, leucopenia, azotaemia, immunoglobulin suppression, and poor treatment response.
Conclusions:
- Infectious complications are frequent in multiple myeloma, with specific risk factors identified.
- Pulmonary and renal infections are the most common types.
- Despite their prevalence and identified risk factors, infectious complications did not significantly affect patient survival.