Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Eur J Haematol. 2019 Feb;102(2):182-190. doi: 10.1111/ejh.13190. Epub 2018 Nov 28.
Infections pose the greatest risk of early death in patients with Multiple Myeloma. However, few studies have analyzed the risk factors for infections in Multiple Myeloma patients. The aim of this study was to analyze the risk factors infections within a population-based MM cohort.
Using Danish registries (from 2005 to 2013), we analyzed all ICD-10 codes for infections within the first 6 months of Multiple Myeloma diagnosis in 2557 patients.
Pneumonia and sepsis represented 46% of infections. Multivariable regression analysis showed that risk factors for pneumonia were male gender (HR 1.4; P = 0.001), ISS II (HR 1.6; P = 0.0004) and ISSIII (HR 1.8; P = 0.0004) and elevated LDH (HR 2.6; P = 0.0008). Risk factors for sepsis were high bone marrow plasma cell % (HR 1.1; P = 0.038), ISS II (HR 1.7; P = 0.007) ISS III (HR 2.0; P = 0.002) and creatinine (HR 2.1; P = 0.002). Neither immunoparesis (hypogammaglobulinemia) nor comorbidity was significant risk factors.
Our study suggests that tumor burden and renal impairment are risk factors for pneumonia and sepsis in the early phase of Multiple Myeloma.
感染是多发性骨髓瘤患者早期死亡的最大风险因素。然而，很少有研究分析多发性骨髓瘤患者感染的危险因素。本研究旨在分析基于人群的多发性骨髓瘤队列中感染的危险因素。
使用丹麦注册中心（2005 年至 2013 年），我们分析了 2557 例多发性骨髓瘤患者诊断后前 6 个月内所有 ICD-10 编码的感染。
肺炎和败血症占感染的 46%。多变量回归分析显示，肺炎的危险因素是男性（HR 1.4；P=0.001）、ISS II（HR 1.6；P=0.0004）和 ISSIII（HR 1.8；P=0.0004）以及升高的 LDH（HR 2.6；P=0.0008）。败血症的危险因素是高骨髓浆细胞%（HR 1.1；P=0.038）、ISS II（HR 1.7；P=0.007）、ISS III（HR 2.0；P=0.002）和肌酐（HR 2.1；P=0.002）。免疫缺陷（低丙种球蛋白血症）和合并症均不是显著的危险因素。
本研究表明，肿瘤负担和肾功能损害是多发性骨髓瘤早期肺炎和败血症的危险因素。
