TY - JOUR
TI - A predictive model for risk of early grade ≥ 3 infection in patients with multiple myeloma not eligible for transplant: Analysis of the FIRST trial
AU - Dumontet, C.
AU - Hulin, C.
AU - Dimopoulos, M.A.
AU - Belch, A.
AU - Dispenzieri, A.
AU - Ludwig, H.
AU - Rodon, P.
AU - Van Droogenbroeck, J.
AU - Qiu, L.
AU - Cavo, M.
AU - Van De Velde, A.
AU - Lahuerta, J.J.
AU - Allangba, O.
AU - Lee, J.H.
AU - Boyle, E.
AU - Perrot, A.
AU - Moreau, P.
AU - Manier, S.
AU - Attal, M.
AU - Roussel, M.
AU - Mohty, M.
AU - Mary, J.Y.
AU - Civet, A.
AU - Costa, B.
AU - Tinel, A.
AU - Gaston-Mathé, Y.
AU - Facon, T.
JO - Leukemia Research
PY - 2018
VL - 32
TODO - 6
SP - 1404-1413
PB - Nature Publishing Group
SN - 0145-2126
TODO - 10.1038/s41375-018-0133-x
TODO - beta 2 microglobulin;  dexamethasone;  hemoglobin;  lactate dehydrogenase;  lenalidomide;  melphalan;  prednisone;  thalidomide, adult;  Article;  bacteremia;  bacterial infection;  cohort analysis;  comparative study;  controlled study;  early infection;  early infection;  hemoglobin blood level;  high risk population;  human;  infection;  infection risk;  lactate dehydrogenase blood level;  low drug dose;  low risk population;  major clinical study;  multicenter study;  multiple cycle treatment;  multiple myeloma;  open study;  overall survival;  prediction;  prognosis;  protein blood level;  randomized controlled trial;  scoring system;  viremia;  complication;  infection;  infection control;  multiple myeloma;  risk factor;  statistical model, Humans;  Infection;  Infection Control;  Logistic Models;  Multiple Myeloma;  Risk Factors
TODO - Infections are a major cause of death in patients with multiple myeloma. A post hoc analysis of the phase 3 FIRST trial was conducted to characterize treatment-emergent (TE) infections and study risk factors for TE grade ≥ 3 infection. The number of TE infections/month was highest during the first 4 months of treatment (defined as early infection). Of 1613 treated patients, 340 (21.1%) experienced TE grade ≥ 3 infections in the first 18 months and 56.2% of these patients experienced their first grade ≥ 3 infection in the first 4 months. Risk of early infection was similar regardless of treatment. Based on the analyses of data in 1378 patients through multivariate logistic regression, a predictive model of first TE grade ≥ 3 infection in the first 4 months retained Eastern Cooperative Oncology Group performance status and serum β 2 -microglobulin, lactate dehydrogenase, and hemoglobin levels to define high- and low-risk groups showing significantly different rates of infection (24.0% vs. 7.0%, respectively; P < 0.0001). The predictive model was validated with data from three clinical trials. This predictive model of early TE grade ≥ 3 infection may be applied in the clinical setting to guide infection monitoring and strategies for infection prevention. © 2018 The Author(s).
ER -