Beyond the M-spike - immunoparesis and multiple myeloma. A narrative review
Abstract
Secondary immunodeficiency or immunoparesis is an acquired impairment of the immune system which is a recognised feature of multiple myeloma (MM). Although classically described as a reduced production of polyclonal immunoglobulins, MM induces global immune dysfunction with defects in innate immune and T cell effector function. Immunoparesis can be detected in premalignant states, including monoclonal gammopathy of uncertain significance. Patients with immunoparesis have a poorer prognosis and present with severe, recurrent infection, which is associated with increased morbidity and mortality especially in the first 3 months following diagnosis, with relapse or progression and with the use of novel therapeutics. Bacterial infections, and specifically pneumonia, are the commonest presentation although there are increased risks of both viral reactivation and invasive fungal infection. Management of immunoparesis in MM includes the use of antimicrobial prophylaxis, and immunoglobulin replacement therapy particularly during high-risk periods. Although vaccination against encapsulated organisms, reactivation viruses, and circulating seasonal viruses is recommended, the response in MM may be suboptimal.
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.