Department of Pharmacy Services, Michigan Medicine and the University of Michigan College of Pharmacy, Ann Arbor, MI, USA.
Division of Hematology and Oncology, Department of Internal Medicine, Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.
Leuk Lymphoma. 2023 Feb;64(2):407-414. doi: 10.1080/10428194.2022.2138380. Epub 2022 Oct 29.
Infections are an important cause of morbidity and mortality in newly diagnosed multiple myeloma (NDMM), but the real-world risk using modern induction regimens such as bortezomib, lenalidomide, and dexamethasone (RVd) is not well described. We performed a retrospective single-center cohort study to identify infections and risk factors in patients treated with first-line RVd from January 2014 to January 2020 and collected demographic and clinical data. Of 144 patients treated with RVd for NDMM, 21 patients (14.5%) experienced a bacterial infection during induction, of which 8 (5.5%) were grade 3 infections despite a low rate of antibiotic prophylaxis use (12%). Grade 3 neutropenia occurred in 11% of patients, 2% had febrile neutropenia and there were no deaths from infection. On multivariable analysis, age, smoking history, diabetes, antibiotic use in the 60 days preceding the start of RVd, and high-risk cytogenetics were associated with higher risk of bacterial infection.
感染是新发多发性骨髓瘤（NDMM）患者发病和死亡的重要原因，但使用硼替佐米、来那度胺和地塞米松（RVd）等现代诱导方案的真实世界风险尚未得到充分描述。我们进行了一项回顾性单中心队列研究，以确定 2014 年 1 月至 2020 年 1 月接受一线 RVd 治疗的患者的感染和相关风险因素，并收集了人口统计学和临床数据。在 144 例接受 RVd 治疗 NDMM 的患者中，21 例（14.5%）在诱导期间发生细菌感染，其中 8 例（5.5%）尽管抗生素预防使用率较低（12%），但为 3 级感染。3 级中性粒细胞减少症的发生率为 11%，2%的患者出现发热性中性粒细胞减少症，无感染死亡病例。多变量分析显示，年龄、吸烟史、糖尿病、RVd 治疗前 60 天内使用抗生素以及高危细胞遗传学与细菌感染风险增加相关。
