학술논문
A simple score to predict early severe infections in patients with newly diagnosed multiple myeloma
Document Type
Original Paper
Author
Encinas, Cristina; Hernandez-Rivas, José-Ángel; Oriol, Albert; Rosiñol, Laura; Blanchard, María-Jesús; Bellón, José-María; García-Sanz, Ramón; de la Rubia, Javier; de la Guía, Ana López; Jímenez-Ubieto, Ana; Jarque, Isidro; Iñigo, Belén; Dourdil, Victoria; de Arriba, Felipe; Pérez-Ávila, Clara Cuéllar; Gonzalez, Yolanda; Hernández, Miguel-Teodoro; Bargay, Joan; Granell, Miguel; Rodríguez-Otero, Paula; Silvent, Maialen; Cabrera, Carmen; Rios, Rafael; Alegre, Adrián; Gironella, Mercedes; Gonzalez, Marta-Sonia; Sureda, Anna; Sampol, Antonia; Ocio, Enrique M.; Krsnik, Isabel; García, Antonio; García-Mateo, Aránzazu; Soler, Joan-Alfons; Martín, Jesús; Arguiñano, José-María; Mateos, María-Victoria; Bladé, Joan; San-Miguel, Jesús F.; Lahuerta, Juan-José; Martínez-López, Joaquín
Source
Blood Cancer Journal. 12(4)
Subject
Language
English
ISSN
2044-5385
Abstract
Infections remain a common complication in patients with multiple myeloma (MM) and are associated with morbidity and mortality. A risk score to predict the probability of early severe infection could help to identify the patients that would benefit from preventive measures. We undertook a post hoc analysis of infections in four clinical trials from the Spanish Myeloma Group, involving a total of 1347 patients (847 transplant candidates). Regarding the GEM2010 > 65 trial, antibiotic prophylaxis was mandatory, so we excluded it from the final analysis. The incidence of severe infection episodes within the first 6 months was 13.8%, and majority of the patients experiencing the first episode before 4 months (11.1%). 1.2% of patients died because of infections within the first 6 months (1% before 4 months). Variables associated with increased risk of severe infection in the first 4 months included serum albumin ≤30 g/L, ECOG > 1, male sex, and non-IgA type MM. A simple risk score with these variables facilitated the identification of three risk groups with different probabilities of severe infection within the first 4 months: low-risk (score 0–2) 8.2%; intermediate-risk (score 3) 19.2%; and high-risk (score 4) 28.3%. Patients with intermediate/high risk could be candidates for prophylactic antibiotic therapies.