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    Imaging, QoL and Patient-Reported Outcome and Supportive Care

    Infections in newly diagnosed multiple myeloma : Incidence, characteristics, and outcome in a tertiary health care centre in India.

    P-129: Infections in newly diagnosed multiple myeloma : Incidence, characteristics, and outcome in a tertiary health care centre in India.

    Thursday, September 26, 2024
    Introduction: Infections are a major cause of morbidity and mortality in patients with multiple myeloma (MM). It is largely due to their compromised immune systems from both the disease and its treatments. Infectious complications and outcomes also vary because of prevalence of multi drug resistant organisms (MDRO) and other background infections besides prophylaxis being used. In this analysis we study characteristics and risk factors for infections among newly diagnosed MM (NDMM) patients at a tertiary healthcare centre in India.

    Methods: A retrospective analysis was conducted using electronic medical records of 181 NDMM patients at a tertiary medical centre in India from July 1, 2022, to October 1, 2023. Data was then entered into an excel spreadsheet and Statistical analysis was performed using SPSS v29. We analysed the baseline disease characteristics, incidence and characteristic of infections, the treatment data, and outcomes. We planned to perform univariate analysis using chi-square test/unpaired t-test followed by a multivariate analysis.

    Results: A total of 181 patients were analysed with a median age of 55 years ( range: 30-85 ) and 121 (66.9%) being males. Comorbidities identified were hypertension (in 33.1% of patients) and diabetes (in 14.9% of patients). Regarding haematological abnormalities at presentation, 97 patients (53%) presented with anaemia, 42 patients (23.2%) had thrombocytopenia, and 18 (9.9%) had neutropenia. Disease characteristics revealed hypercalcemia in 24 patients (13.3%), hypoalbuminemia in 64 patients (35.4%), and raised LDH in 81 patients (44.8%). Renal damage was evident in 44 patients (24.3%) at presentation, while 154 patients (85.1%) had bony lesions. R-ISS stage I, II, III comprised 8.8%, 43.6%, 28.2% respectively.



    Infections were documented in 76 patients (42%). Among these 23 (30.2%) had bacterial infection, 15 (19.7%) had viral infection with only one patient (1.3%) having fungal infection .Sites of infection were LRTI in 41 (53.9%) , 20 (26.3%) had URTI, 2 (2.63%) patients had UTI, 3 (3.94%) patients had soft tissue infection and tuberculosis infection in 3 (3.94%) patients. Out of the 76 patients 25 (32.9%) patients had microbiologically defined infection as a result of culture positivity. Number of episodes of infection were one in 43 (56.5%) patients, two episodes in 18 (23.6%) patients and more than two in 12 (15.7%) patients. Eight (10.5%) patients required admission to the ICU and 5 (6.5%) individuals died due to infections. On univariate analysis only absolute neutrophil count less than 2 x 10e9/L at baseline was found to be associated with increased risk of infection.

    Conclusions: The study reveals a high incidence of infection rate among NDMM patients in our cohort with a significant infection-related mortality rate of 6.5%. These findings highlight the importance of vigilant infection monitoring and management in this patient population and suggest caution while using intensive regimens.