Infection incidence, timing, and predictors in newly diagnosed multiple myeloma: a real-world retrospective cohort study
Abstract
Background Infections are a leading cause of morbidity and mortality in multiple myeloma (MM), particularly during the induction phase. Identifying real-world infection patterns and predictors is crucial for guiding preventive strategies. Methods This retrospective cohort study included 161 newly diagnosed MM patients who received standard induction therapy at a single tertiary center between 2016 and 2024. Clinical, laboratory, and infection-related parameters were analyzed, with infection during the first 6 months defined as the primary outcome and 12-months analyses as secondary outcomes. Results Infections occurred in 50.9% of patients, with the highest incidence within the first 3 months (27.3%, p = 0.004). Pneumonia was the most common type (34.1%), and gram-negative bacteria, particularly Escherichia coli, Klebsiella spp., and Pseudomonas aeruginosa, were predominant. Antibiotic resistance to TMP-SMX and levofloxacin was observed in E. coli isolates. Multivariate analysis identified advanced ISS stage (OR: 3.83), diabetes mellitus (OR: 3.64), and chronic kidney disease (OR: 6.01) as independent predictors of infection (p < 0.05). Lymphocyte counts were significantly lower in febrile episodes (p = 0.040), suggesting a potential association with immune status, although this finding should be interpreted cautiously. Hospitalization was more common in patients with advanced ISS and kidney disease. No significant differences were found between induction regimens.…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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