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Infection risks in multiple myeloma: A systematic review and meta-analysis of randomized trials from 2015 to 2019
Balmaceda, Nicole Aziz, Muhammad Chandrasekar, Viveksandeep Thoguluva McClune, Brian Kambhampati, Suman Shune, Leyla Abdallah, Al-Ola Anwer, Faiz Majeed, Aneela Qazilbash, Muzaffar
Balmaceda, Nicole
Aziz, Muhammad
Chandrasekar, Viveksandeep Thoguluva
McClune, Brian
Kambhampati, Suman
Shune, Leyla
Abdallah, Al-Ola
Anwer, Faiz
Majeed, Aneela
Qazilbash, Muzaffar
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Abstract
Background
Patients with multiple myeloma (MM) remain at an increased risk of infection due to the disease process, as well as the ensuing treatments.
Methods
We performed a systematic review to evaluate the monthly risk of grade III/IV infection, pneumonia, and neutropenia in patients with myeloma enrolled in randomized clinical trials (RCTs).
Results
The risk of grade III or higher infection, pneumonia, and neutropenia persists among all phases of treatment. There was no statistical difference in grade III or higher infection, pneumonia, and neutropenia between frontline and relapsed/refractory setting. In the maintenance setting, the complications of infection, pneumonia, and neutropenia were low, but not negligible. Three-drug regimens were no more likely than two-drug regimens to have an increased risk of Grade III or higher infection.
Conclusions
This is the first study to quantify the monthly risk of grade III or higher infection, pneumonia, and neutropenia across different treatment regimens in the frontline, maintenance, and relapsed/refractory settings. The results of our systematic review demonstrate a significant risk for severe infection, pneumonia, and neutropenia in patients with MM. Further studies are needed to determine the value of antibiotic prophylaxis in a broader myeloma patient population, as well as other approaches that will further mitigate the morbidity and mortality related to infection in this vulnerable patient population.
Description
A grant from the One-University Open Access Fund at the University of Kansas was used to defray the author's publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml.
Date
2021-06-26
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BMC
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Balmaceda_2021.pdf
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Keywords
Multiple myeloma, Proteasome inhibitors, Anti-CD38, Cytotoxic therapy, Infection
Citation
Balmaceda, N., Aziz, M., Chandrasekar, V.T. et al. Infection risks in multiple myeloma: a systematic review and meta-analysis of randomized trials from 2015 to 2019. BMC Cancer 21, 730 (2021). https://doi.org/10.1186/s12885-021-08451-x