In a nutshell
This paper reviewed the effect of thearpies that act on the immune system on the risk of infection. The study concluded that patients receiving these drugs are at a high risk of serious infection.
Treatment for multiple myeloma now generally includes immunomodulators and stem cell transplantation. Immunomodulators stimulate the immune system and can help to block cancer growth. Examples of immunomodulatory therapies are thalidomide (Thalomid), lenalidomide (Revlimid) and pomalidomide (Imnovid). However, these drugs are associated with a decrease in levels of white blood cells. This increases the risk of infection. The risk of serious infection with these treatments is still under investigation.
Methods & findings
This study reviewed the results of 45 trials including 11,617 patients. Patients were followed between 10 and 55 months.
For patients treated with thalidomide who were eligible for transplant, 14.8% had a serious infection during first (induction) treatment. For patients who were not eligible for transplant, 11% had a serious infection during induction. 12.3% of patients had a serious infection during lenalidomide induction treatment. 7.2% of patients with relapsed or refractory (did not respond to treatment) multiple myeloma had a serious infection.
Of 384 patients who received pomalidomide, 28.4% had a serious infection. 23% of patients with relapsed or refractory multiple myeloma had a serious infection.
Lenalidomide was associated with 2.45 times the risk of serious infection compared to conventional therapy. In patients eligible for transplant, risk of serious infection at the start of thalidomide treatment was 18% lower compared to conventional therapy.
4 studies looked at relapsed or refractory multiple myeloma. Those who received immunomodulatory drugs were 38% more likely to have a serious infection than patients who received conventional therapy.
The bottom line
The authors concluded that patients who received immunomodulatory drugs for multiple myeloma are at a high risk of serious infection.
Talk to your doctor about ways to reduce your risk of infection.
Published By :
Annals of Hematology
Mar 02, 2018
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