A simple score to predict early severe infections in patients with newly diagnosed multiple myeloma
Por:
Encinas, C, Hernandez-Rivas, JA, Oriol, A, Rosinol, L, Blanchard, MJ, Bellon, JM, Garcia-Sanz, R, de la Rubia, J, de la Guia, AL, Jimenez-Ubieto, A, Jarque, I, Inigo, B, Dourdil, V, de Arriba, F, Perez-Avila, CC, Gonzalez, Y, Hernandez, MT, Bargay, J, Granell, M, Rodriguez-Otero, P, Silvent, M, Cabrera, C, Rios, R, Alegre, A, Gironella, M, Gonzalez, MS, Sureda, A, Sampol, A, Ocio, EM, Krsnik, I, Garcia, A, Garcia-Mateo, A, Soler, JA, Martin, J, Arguinano, JM, Mateos, MV, Blade, J, San-Miguel, JF, Lahuerta, JJ, Martinez-Lopez, J
Publicada:
19 abr 2022
Resumen:
Infections remain a common complication in patients with multiple myeloma (MM) and are associated with morbidity and mortality. A risk score to predict the probability of early severe infection could help to identify the patients that would benefit from preventive measures. We undertook a post hoc analysis of infections in four clinical trials from the Spanish Myeloma Group, involving a total of 1347 patients (847 transplant candidates). Regarding the GEM2010 > 65 trial, antibiotic prophylaxis was mandatory, so we excluded it from the final analysis. The incidence of severe infection episodes within the first 6 months was 13.8%, and majority of the patients experiencing the first episode before 4 months (11.1%). 1.2% of patients died because of infections within the first 6 months (1% before 4 months). Variables associated with increased risk of severe infection in the first 4 months included serum albumin <= 30 g/L, ECOG > 1, male sex, and non-IgA type MM. A simple risk score with these variables facilitated the identification of three risk groups with different probabilities of severe infection within the first 4 months: low-risk (score 0-2) 8.2%; intermediate-risk (score 3) 19.2%; and high-risk (score 4) 28.3%. Patients with intermediate/high risk could be candidates for prophylactic antibiotic therapies.
Filiaciones:
Encinas, C:
Hosp Gen Univ Gregorio Maranon HGUGM, IiSGM, Madrid, Spain
Hernandez-Rivas, JA:
Hosp Univ Infanta Leonor, Madrid, Spain
Oriol, A:
Hosp Badalona Germans Trias & Pujol, Barcelona, Barcelona, Spain
Rosinol, L:
Hosp Clin Barcelona, CIBERONC, Barcelona, Spain
Blanchard, MJ:
Hosp Univ Ramon y Cajal, Madrid, Spain
Bellon, JM:
Hosp Gen Univ Gregorio Maranon HGUGM, IiSGM, Madrid, Spain
Garcia-Sanz, R:
Univ Hosp Salamanca HUS IBSAL, CIBERONC, Salamanca, Spain
Canc Res Inst Salamanca IBMCC USAL CSIC, Salamanca, Spain
de la Rubia, J:
Hosp Univ Doctor Peset, Valencia, Spain
de la Guia, AL:
Hosp Univ La Paz, Madrid, Spain
Jimenez-Ubieto, A:
Hosp Univ 12 Octubre, CIBERONC, Madrid, Spain
Jarque, I:
Hosp Univ La Fe, CIBERONC, Valencia, Spain
Inigo, B:
Hosp Clin San Carlos, Madrid, Spain
Dourdil, V:
Hosp Clin Univ Lozano Blesa, IIS Aragon, Zaragoza, Spain
de Arriba, F:
Hosp JM Morales Meseguer, Murcia, Spain
Perez-Avila, CC:
Hosp Univ 12 Octubre, CIBERONC, Madrid, Spain
Gonzalez, Y:
Hosp Univ Dr Josep Trueta, Girona, Spain
Hernandez, MT:
Hosp Univ Canarias, San Cristobal La Laguna, Spain
Bargay, J:
Hosp Son Llatzer, Palma De Mallorca, Spain
Granell, M:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Rodriguez-Otero, P:
Clin Univ Navarra, CIMA, IDISNA, Pamplona, Spain
CIBERONC, Pamplona, Spain
Silvent, M:
Hosp Donostia, San Sebastian, Spain
Cabrera, C:
Complejo Hosp Caceres, Caceres, Spain
Rios, R:
Hosp Univ Virgen de las Nieves, Granada, Spain
Alegre, A:
Hosp Univ La Princesa, Madrid, Spain
Hosp Univ Quironsalud, Madrid, Spain
Gironella, M:
Hosp Valle De Hebron, Barcelona, Spain
Gonzalez, MS:
Hosp Univ Santiago, Santiago De Compostela, Spain
Sureda, A:
Univ Barcelona, IDIBELL, ICO Hosp, Barcelona, Spain
Sampol, A:
Hosp Univ Son Espases, Palma De Mallorca, Spain
Ocio, EM:
Univ Cantabria, IDIVAL, Hosp Univ Marques de Valdecilla, Santander, Spain
Krsnik, I:
Hosp Univ Puerta de Hierro Majadahonda, Madrid, Spain
Garcia, A:
Hosp Arnau Vilanova, Lleida, Spain
Garcia-Mateo, A:
Hosp Gen Segovia, Segovia, Spain
Soler, JA:
Hosp Parc Tauli, Barcelona, Barcelona, Spain
Martin, J:
Complejo Hosp Reg Virgen del Rocio, CIBERONC, Seville, Spain
Arguinano, JM:
Complejo Hosp Navarra, Pamplona, Spain
Mateos, MV:
Univ Hosp Salamanca HUS IBSAL, CIBERONC, Salamanca, Spain
Canc Res Inst Salamanca IBMCC USAL CSIC, Salamanca, Spain
Blade, J:
Hosp Clin Barcelona, CIBERONC, Barcelona, Spain
San-Miguel, JF:
Clin Univ Navarra, CIMA, IDISNA, Pamplona, Spain
CIBERONC, Pamplona, Spain
Lahuerta, JJ:
Hosp Univ 12 Octubre, CIBERONC, Madrid, Spain
Martinez-Lopez, J:
Hosp Univ 12 Octubre, CIBERONC, Madrid, Spain
gold, Green Published
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