Epidemiology and Risk Factors for the Development of Infectious Complications in Newly Diagnosed Multiple Myeloma: A Multicenter Prospective Cohort Study in Latin America

PURPOSEInfections are a significant cause of morbidity and mortality in patients with multiple myeloma (MM). In Latin America, data on infectious complications in this patient population are lacking.METHODSWe conducted a prospective cohort study of patients with newly diagnosed MM (NDMM) in seven La...

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Main Authors: Virginia Bove, Eloísa Riva, Jule Vásquez, Camila Peña, Cristian Seehaus, César Samanez, Justina Bustos, Marcos Hernández, Julio Fernández, Oliday Ríos, Yusaima Rodríguez, Irving Figueredo, Dorotea Fantl, Luis Malpica
Format: Article
Language:English
Published: American Society of Clinical Oncology 2022-07-01
Series:JCO Global Oncology
Online Access:https://ascopubs.org/doi/10.1200/GO.22.00068
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author Virginia Bove
Eloísa Riva
Jule Vásquez
Camila Peña
Cristian Seehaus
César Samanez
Justina Bustos
Marcos Hernández
Julio Fernández
Oliday Ríos
Yusaima Rodríguez
Irving Figueredo
Dorotea Fantl
Luis Malpica
author_facet Virginia Bove
Eloísa Riva
Jule Vásquez
Camila Peña
Cristian Seehaus
César Samanez
Justina Bustos
Marcos Hernández
Julio Fernández
Oliday Ríos
Yusaima Rodríguez
Irving Figueredo
Dorotea Fantl
Luis Malpica
author_sort Virginia Bove
collection DOAJ
description PURPOSEInfections are a significant cause of morbidity and mortality in patients with multiple myeloma (MM). In Latin America, data on infectious complications in this patient population are lacking.METHODSWe conducted a prospective cohort study of patients with newly diagnosed MM (NDMM) in seven Latin American countries between June 2019 and May 2020. Patients with active disease, on active therapy, and with a follow-up of 6 months from the time of diagnosis were included. Our primary end point was the number of infectious events that required hospitalization for ≥ 24 hours.RESULTSOf 248 patients with NDMM, 89 (35.9%) had infectious complications (113 infectious events), the majority (67.3%) within the first 3 months from diagnosis. The most common sites of infection were respiratory (38%) and urinary tract (31%). The microbial agent was identified in 57.5% of patients with gram-negative bacteria (73.5%) as the most common pathogen. Viral infections were infrequent, and no patients with fungal infection were reported. In the multivariable analysis, diabetes mellitus (odds ratio [OR], 2.71; 95% CI, 1.23 to 6.00; P = .014), creatinine ≥ 2 mg/dL (OR, 4.87; 95% CI, 2.29 to 10.35; P < .001), no use of trimethoprim-sulfamethoxazole prophylaxis (OR, 6.66; 95% CI, 3.43 to 12.92; P < .001), and treatment with immunomodulatory drugs (OR, 3.02; 95% CI, 1.24 to 6.29; P = .003) were independent factors associated with bacterial infections. At 6 months, 21 patients (8.5%) had died, 47.6% related to infectious complications.CONCLUSIONBacterial infections are a substantial cause of hospital admissions and early death in patients with NDMM. Antibiotic prophylaxis should be considered to reduce infectious complications in patients with MM.
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spelling doaj.art-95c7769637744ff199a82503475b200e2022-12-22T00:45:46ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412022-07-01810.1200/GO.22.00068Epidemiology and Risk Factors for the Development of Infectious Complications in Newly Diagnosed Multiple Myeloma: A Multicenter Prospective Cohort Study in Latin AmericaVirginia Bove0Eloísa Riva1Jule Vásquez2Camila Peña3Cristian Seehaus4César Samanez5Justina Bustos6Marcos Hernández7Julio Fernández8Oliday Ríos9Yusaima Rodríguez10Irving Figueredo11Dorotea Fantl12Luis Malpica13Department of Hematology, Hospital Central de las FF.AA., Montevideo, UruguayDepartment of Hematology, Hospital de Clínicas, Montevideo, UruguayDepartment of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, PeruDepartment of Hematology, Hospital del Salvador, Santiago, ChileDepartment of Hematology, Hospital Italiano de Buenos Aires, Buenos Aires, ArgentinaDepartment of Medical Oncology, Oncosalud—AUNA, Lima, PeruDepartment of Hematology and Bone Marrow Transplantation, Instituto Oncológico Nacional, Panamá, PanamáDepartment of Hematology, Universidad de Carabobo, Hospital Metropolitano del Norte, Carabobo, VenezuelaDepartment of Hematology, Hospital General Universitario Dr Gustavo Aldereguía Lima, Cienfuegos, CubaDepartment of Hematology, Hospital Hermanos Ameijeiras, La Habana, CubaDepartment of Hematology, Hospital Hermanos Ameijeiras, La Habana, CubaDepartment of Hematology, Centro de Investigaciones Médico Quirúrgicas, La Habana, CubaDepartment of Hematology, Hospital Italiano de Buenos Aires, Buenos Aires, ArgentinaDepartment of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TXPURPOSEInfections are a significant cause of morbidity and mortality in patients with multiple myeloma (MM). In Latin America, data on infectious complications in this patient population are lacking.METHODSWe conducted a prospective cohort study of patients with newly diagnosed MM (NDMM) in seven Latin American countries between June 2019 and May 2020. Patients with active disease, on active therapy, and with a follow-up of 6 months from the time of diagnosis were included. Our primary end point was the number of infectious events that required hospitalization for ≥ 24 hours.RESULTSOf 248 patients with NDMM, 89 (35.9%) had infectious complications (113 infectious events), the majority (67.3%) within the first 3 months from diagnosis. The most common sites of infection were respiratory (38%) and urinary tract (31%). The microbial agent was identified in 57.5% of patients with gram-negative bacteria (73.5%) as the most common pathogen. Viral infections were infrequent, and no patients with fungal infection were reported. In the multivariable analysis, diabetes mellitus (odds ratio [OR], 2.71; 95% CI, 1.23 to 6.00; P = .014), creatinine ≥ 2 mg/dL (OR, 4.87; 95% CI, 2.29 to 10.35; P < .001), no use of trimethoprim-sulfamethoxazole prophylaxis (OR, 6.66; 95% CI, 3.43 to 12.92; P < .001), and treatment with immunomodulatory drugs (OR, 3.02; 95% CI, 1.24 to 6.29; P = .003) were independent factors associated with bacterial infections. At 6 months, 21 patients (8.5%) had died, 47.6% related to infectious complications.CONCLUSIONBacterial infections are a substantial cause of hospital admissions and early death in patients with NDMM. Antibiotic prophylaxis should be considered to reduce infectious complications in patients with MM.https://ascopubs.org/doi/10.1200/GO.22.00068
spellingShingle Virginia Bove
Eloísa Riva
Jule Vásquez
Camila Peña
Cristian Seehaus
César Samanez
Justina Bustos
Marcos Hernández
Julio Fernández
Oliday Ríos
Yusaima Rodríguez
Irving Figueredo
Dorotea Fantl
Luis Malpica
Epidemiology and Risk Factors for the Development of Infectious Complications in Newly Diagnosed Multiple Myeloma: A Multicenter Prospective Cohort Study in Latin America
JCO Global Oncology
title Epidemiology and Risk Factors for the Development of Infectious Complications in Newly Diagnosed Multiple Myeloma: A Multicenter Prospective Cohort Study in Latin America
title_full Epidemiology and Risk Factors for the Development of Infectious Complications in Newly Diagnosed Multiple Myeloma: A Multicenter Prospective Cohort Study in Latin America
title_fullStr Epidemiology and Risk Factors for the Development of Infectious Complications in Newly Diagnosed Multiple Myeloma: A Multicenter Prospective Cohort Study in Latin America
title_full_unstemmed Epidemiology and Risk Factors for the Development of Infectious Complications in Newly Diagnosed Multiple Myeloma: A Multicenter Prospective Cohort Study in Latin America
title_short Epidemiology and Risk Factors for the Development of Infectious Complications in Newly Diagnosed Multiple Myeloma: A Multicenter Prospective Cohort Study in Latin America
title_sort epidemiology and risk factors for the development of infectious complications in newly diagnosed multiple myeloma a multicenter prospective cohort study in latin america
url https://ascopubs.org/doi/10.1200/GO.22.00068
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