Dipartimento di Ematologia, Oncologia, e Dermatologia, Azienda Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
'Seràgnoli' Institute of Hematology, Bologna University School of Medicine, Bologna, Italy.
Blood Rev. 2019 Mar;34:84-94. doi: 10.1016/j.blre.2019.01.001. Epub 2019 Jan 9.
The introduction of new therapeutic agents in multiple myeloma (MM), including proteasome inhibitors, immunoregulatory drugs and monoclonal antibodies, has improved the outcomes of patients, but in parallel has changed the frequency and epidemiology of infections. Hence, the great strides in the indications and use of new active treatments for MM need parallel progresses on the best approach to prophylaxis and supportive therapy for infections. Moving from the recognition that the above issue represents an unmet clinical need in MM, an expert panel assessed the scientific literature and composed a framework of recommendations for optimal infection control in patients candidate to active treatment for MM. The present publication represents a consensus document from questionnaires and consensus meetings held during 2017. The issues tackled in the project dealt with: infectious risk assessment, risk management and prophylaxis, intravenous immunoglobulin replacement therapy, antiviral and antibacterial vaccination. Considering the lack of conclusive and/or enough large studies for certain topics several recommendations derived from the personal experience of the experts.
在多发性骨髓瘤(MM)中引入新的治疗药物,包括蛋白酶体抑制剂、免疫调节剂和单克隆抗体,已经改善了患者的预后,但同时也改变了感染的频率和流行病学。因此,新的针对 MM 的有效治疗方法的应用指征有了很大的进步,需要在感染的预防和支持治疗方面取得同步进展。鉴于认识到上述问题是 MM 中未满足的临床需求,一个专家小组评估了科学文献,并为准备接受 MM 积极治疗的患者制定了最佳感染控制建议框架。本出版物代表了在 2017 年进行的问卷调查和共识会议达成的共识文件。该项目涉及的问题有:感染风险评估、风险管理和预防、静脉注射免疫球蛋白替代疗法、抗病毒和抗菌疫苗接种。考虑到某些主题缺乏确凿和/或足够的大型研究,一些建议来自专家的个人经验。