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

• Autores: Bove, V, Riva, E, Vásquez-Chavez, J, Peña, C, Seehaus, C, Samanez, C, Bustos, J, Hernández, M, Fernández, J, Ríos, O, Rodríguez, Y, Figueredo, I, Fantl, D, Malpica, L
• Formato: artículo
• Fecha de Publicación: 2022
• Institución: Instituto Nacional de Enfermedades Neoplásicas
• Repositorio: INEN-Institucional
• Lenguaje: inglés
• OAI Identifier: oai:repositorio.inen.sld.pe:20.500.14703/323
• Enlace del recurso: https: //doi.org/10.1200/GO.22.00068; https://hdl.handle.net/20.500.14703/323
• Nivel de acceso: acceso abierto
• Materia: Bacterial Infections; Humans; Latin America; Multiple Myelom; Prospective Studies; Risk Factors; Multiple Myeloma; https://purl.org/pe-repo/ocde/ford#3.02.21

PURPOSE: Infections 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. METHODS: We 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. RESULTS: Of 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. CONCLUSION: Bacterial 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.