Περίληψη:
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).
Συγγραφείς:
Dumontet, C.
Hulin, C.
Dimopoulos, M.A.
Belch, A.
Dispenzieri, A.
Ludwig, H.
Rodon, P.
Van Droogenbroeck, J.
Qiu, L.
Cavo, M.
Van De Velde, A.
Lahuerta, J.J.
Allangba, O.
Lee, J.H.
Boyle, E.
Perrot, A.
Moreau, P.
Manier, S.
Attal, M.
Roussel, M.
Mohty, M.
Mary, J.Y.
Civet, A.
Costa, B.
Tinel, A.
Gaston-Mathé, Y.
Facon, T.
Λέξεις-κλειδιά:
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
