In a nutshell
This study examined the risk factors for blood stream infection in patients with multiple myeloma. The study determined that patients with later stage disease are at highest risk of developing an infection.
Some background
Patients with multiple myeloma have an increased risk of infection. Infections are the leading cause of early deaths in multiple myeloma. However, few studies have looked at the risk factors for serious blood stream infections in multiple myeloma. Knowing risk factors for serious infection can better help with prevention.
Methods & findings
This study included information on 1154 patients with newly diagnosed multiple myeloma. Patients were followed-up for an average 1428 days.
From day -1000 to day +2000 from diagnosis, there were a total of 6061 blood culture days. 5514 days showed no infection. 431 days showed infection in the blood. 116 showed possible contamination. Patients underwent the most blood cultures during the first 6 months from diagnosis.
The highest occurrence of infection was during the first 6 months from diagnosis. In the first 6 months from diagnosis, there were a total of 2425 blood cultures done. 7% of these cultures showed infection. 97% of the infections were bacterial. 3% were fungal. The most frequent bacteria found were E.coli, S.aureus, E.faecium, S.pneumoniae and E.faecalis.
Risk factors for having a blood culture performed were a weakened immune system and higher stage multiple myeloma. High levels of LDH (blood measure of cell damage) also meant an increased risk of having a blood culture performed. Having stage 3 multiple myeloma doubled the risk of infection during the first 6 months. A high LDH level also increased the risk of infection 3.4-fold.
The bottom line
The authors concluded that blood stream infections are most commonly seen in the early phase of multiple myeloma. Patients with aggressive disease are at increased risk of getting an infection.
Published By :
European Journal of Haematology
Date :
Mar 22, 2018
