Scientific publications

A simple score to predict early severe infections in patients with newly diagnosed multiple myeloma. Scientific Publication

Apr 19, 2022 | Magazine: Blood Cancer Journal

Cristina Encinas #  1 , José-Ángel Hernandez-Rivas #  2 , Albert Oriol  3 , Laura Rosiñol  4 , María-Jesús Blanchard  5 , José-María Bellón  1 , Ramón García-Sanz  6 , Javier de la Rubia  7 , Ana López de la Guía  8 , Ana Jímenez-Ubieto  9 , Isidro Jarque  10 , Belén Iñigo  11 , Victoria Dourdil  12 , Felipe de Arriba  13 , Clara Cuéllar Pérez-Ávila  9 , Yolanda Gonzalez  14 , Miguel-Teodoro Hernández  15 , Joan Bargay  16 , Miguel Granell  17 , Paula Rodríguez-Otero  18 , Maialen Silvent  19 , Carmen Cabrera  20 , Rafael Rios  21 , Adrián Alegre  22 , Mercedes Gironella  23 , Marta-Sonia Gonzalez  24 , Anna Sureda  25 , Antonia Sampol  26 , Enrique M Ocio  27 , Isabel Krsnik  28 , Antonio García  29 , Aránzazu García-Mateo  30 , Joan-Alfons Soler  31 , Jesús Martín  32 , José-María Arguiñano  33 , María-Victoria Mateos  6 , Joan Bladé  4 , Jesús F San-Miguel  18 , Juan-José Lahuerta  9 , Joaquín Martínez-López  34 , GEM/PETHEMA (Grupo Español de Mieloma/Programa para el Estudio de la Terapéutica en Hemopatías Malignas) cooperative study group


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.

CITATION  Blood Cancer J. 2022 Apr 19;12(4):68. doi: 10.1038/s41408-022-00652-2

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