Valkovic Toni, Marcelic Lucija, Valkovic Frane
Special Hospital Medico, Rijeka, Croatia.
Faculty of Health Studies, University of Rijeka, Rijeka, Croatia.
Ther Adv Infect Dis. 2024 Mar 26;11:20499361241238518. doi: 10.1177/20499361241238518. eCollection 2024 Jan-Dec.
Multiple myeloma is among the most common hematological malignancies and is characterized by a strong susceptibility to infections primarily bacterial and viral and, to a much lesser extent, fungal. There appears to be a slightly increasing frequency of invasive fungal infections. This is attributed to the use of different combinations of newer drugs and patients' exposure to increasing therapeutic lines, and thus to risk factors for invasive fungal infections, especially severe and long-term neutropenia. Novel immunotherapy modalities including bispecific antibodies and chimeric antigen receptor T-cell therapy are being introduced for the treatment of relapsing-refractory forms of the disease. Consequently, in the near future, it can be expected that myeloma patients will exhibit a significantly increased frequency of invasive fungal infections. Therefore, we must carefully monitor all epidemiological trends related to invasive fungal infections in patients with multiple myeloma, both in clinical studies and in real life. This will help us learn to prevent fungal infections, as well as quickly recognize and treat them to reduce their impact on patients' morbidity and mortality. In this review article, we describe in detail the epidemiological characteristics of invasive fungal infections in myeloma patients, the risk factors for these infections, and the treatment and prevention options.
多发性骨髓瘤是最常见的血液系统恶性肿瘤之一，其特点是对感染具有高度易感性，主要是细菌和病毒感染，真菌感染的程度要小得多。侵袭性真菌感染的频率似乎略有上升。这归因于新型药物的不同组合使用以及患者接受越来越多的治疗疗程，从而导致侵袭性真菌感染的风险因素增加，尤其是严重和长期的中性粒细胞减少。包括双特异性抗体和嵌合抗原受体T细胞疗法在内的新型免疫治疗方式正在被引入用于治疗复发难治性骨髓瘤。因此，在不久的将来，可以预期骨髓瘤患者侵袭性真菌感染的频率将显著增加。因此，我们必须在临床研究和现实生活中仔细监测多发性骨髓瘤患者与侵袭性真菌感染相关的所有流行病学趋势。这将有助于我们学会预防真菌感染，并迅速识别和治疗它们，以减少其对患者发病率和死亡率的影响。在这篇综述文章中，我们详细描述了骨髓瘤患者侵袭性真菌感染的流行病学特征、这些感染的风险因素以及治疗和预防方案。
