Antibiotic prophylaxis should be considered an option for patients with newly diagnosed multiple myeloma (MM) to reduce the risk of early death from bacterial infections, according to investigators in a prospective study.
The cohort study enrolled a total of 248 patients with newly diagnosed MM in seven Latin American countries between June 2019 and May 2020. Patients were included if they had active disease, were on active therapy, and had a follow-up at least six months from diagnosis and before proceeding to autologous hematopoietic stem cell transplantation (AHSCT) or death. The primary endpoint was the number of infectious events that required hospitalization for 24 hours or more.
Among all patients, 89 (35.9%) had infectious complications (113 infectious events), the majority (67.3%) of which occurred within the first three 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%) being the most common pathogen. Viral infections were infrequent, and no patients reported fungal infection. At six months, 21 patients (8.5%) had died, 47.6% of which were related to infectious complications.
Multivariable analysis revealed several independent factors associated with bacterial infections (see TABLE 1).
“Bacterial infections are a substantial cause of hospital admissions and early death,” the investigators concluded.
Reference
Bove V, Riva E, Vásquez J, et al. Epidemiology and risk factors for the development of infectious complications in newly diagnosed multiple myeloma: a multicenter prospective cohort study in Latin America. JCO Glob Oncol. 2022. doi:10.1200/GO.22.00068