Invasive fungal infections in patients with multiple myeloma: a multi-center study in the era of novel myeloma therapies

Risks, severity and timing of infections in patients with multiple myeloma: a longitudinal cohort study in the era of immunomodulatory drug therapy

“…This reaffirms the higher toxicity seen with use of high dose dexamethasone in myeloma treatment and provides support for moves towards lower dosing (Rajkumar et al , ). Increasing lines of therapy can further compound the risk of bacterial infection, a result of cumulative immunosuppression and delayed immune recovery (Schütt et al , ; Teh et al , ,c).…”

“…However, the treatment of MM has since undergone a paradigm shift with the routine use of immunomodulatory drugs (IMiDs) and proteasome inhibitors (PI) as the standard of care for induction therapy in combination with autologous haematopoietic stem cell transplant (ASCT) as consolidation for eligible patients (Teh et al , ). Our recent studies have suggested a shift in the pattern of viral and fungal infections with multiply treated patients and progressive disease at increased risk (Teh et al , ,c).…”

Intracranial involvement by multiple myeloma

“…20 Differentiation by lumbar puncture between myelomatous leptomeningeal involvement and infection remains important in a patient with a known MM, as the appearances can be similar and patients with MM are at increased risk of infections. 3,21 Parenchymal involvement Parenchymal involvement is the least common form of intracranial involvement by MM. 10 Parenchymal involvement can occur haematogenously or secondary to direct extension from dural or leptomeningeal disease.…”

Infections in Patients with Multiple Myeloma in the Era of Novel Agents and Stem Cell Therapies

“…Candidemia and IFIs are major complications in patients with HMs who develop prolonged and severe neutropenia. Additionally, IFIs are difficult to diagnose in these severely immunocompromised patients [88][89][90][91]. In patients with MM prior to the introduction of novel therapies, IFIs were encountered in patients treated with traditional intensive cytotoxic chemotherapeutic regimens and mortality rates due to IFIs were reaching 60% [91].…”

“…Additionally, IFIs are difficult to diagnose in these severely immunocompromised patients [88][89][90][91]. In patients with MM prior to the introduction of novel therapies, IFIs were encountered in patients treated with traditional intensive cytotoxic chemotherapeutic regimens and mortality rates due to IFIs were reaching 60% [91]. In the era of novel therapies, IFIs are associated with mortality rate of approximately 44% and are mainly encountered in MM patients having: (1) progressive disease, (2) ≥ 3 lines of therapy administered, (3) received HSCT, particularly in the early post-transplant period, and (4) history of IFI treated [91][92][93].…”