title: MBL2 polymorphism and risk of severe infections in multiple myeloma patients receiving high-dose melphalan and autologous stem cell transplantation.
abstract: Severe infections related to treatment are common in patients with multiple myeloma (MM). Genetic polymorphisms of the immune system may influence the risk of infections. Mannan-binding lectin (MBL) is part of the innate immune system, and individuals homozygous for wild-type MBL encoding gene (MBL2) have a well-functioning MBL pathway of complement activation, in contrast to individuals carrying one or two variant alleles. We evaluated 113 courses of high-dose melphalan and autologous stem cell transplantation (ASCT) in patients with MM. Patients homozygous for wild-type MBL2 had a significantly reduced risk of septicaemia during the ASCT procedure compared with patients carrying variant MBL2: Odds Ratio (OR) 0.19 (95% CI: 0.04-0.77), (P=0.02) in multivariate analysis. The risk of Common Toxicity Criteria grade 3-4 infections in general was not affected by wild-type MBL2: OR 1.20 (95% CI: 0.52-2.78), (P=0.67). The findings indicate that MBL to some extent protects against the most severe infections during ASCT.
authors.affiliation: Department of Haematology, University Hospital of Aarhus, THG, Aarhus, Denmark. im@dadlnet.dk
authors.forename: I
authors.initials: I
authors.lastname: Mølle
authors.forename: N A
authors.initials: NA
authors.lastname: Peterslund
authors.forename: S
authors.initials: S
authors.lastname: Thiel
authors.forename: R
authors.initials: R
authors.lastname: Steffensen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007109:Immunity / Q000235:genetics; D007239:Infections / Q000209:etiology* / Q000235:genetics; D008297:Male; D037601:Mannose-Binding Lectin / Q000235:genetics* / Q000276:immunology; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000235:genetics; D011110:Polymorphism, Genetic / Q000276:immunology*; D012189:Retrospective Studies; D012306:Risk; D014182:Transplantation, Autologous
chemical_list: C445619:MBL2 protein, human; D037601:Mannose-Binding Lectin; D008558:Melphalan