title: Pretreatment Lymphopenia, Poor Performance Status, and Early Courses of Therapy Are Risk Factors for Severe Bacterial Infection in Patients with Multiple Myeloma during Treatment with Bortezomib-based Regimens.
abstract: The aim of this study was to identify the risk factors associated with severe bacterial infection (SBI) in multiple myeloma (MM) patients during treatment with bortezomib-based regimens. A total of 98 patients with MM were evaluated during 427 treatment courses. SBI occurred in 57.1% (56/98) of the patients and during 19.0% (81/427) of the treatment courses. In the multivariate analysis for the factors associated with the development of SBI in each treatment course, poor performance status (Eastern Cooperative Oncology Group ≥ 2, P < 0.001), early course of therapy (≤ 2 courses, P < 0.001), and pretreatment lymphopenia (absolute lymphocyte count < 1.0 × 10(9)/L, P = 0.043) were confirmed as independent risk factors. The probability of developing SBI were 5.1%, 14.9%, 23.9% and 59.5% in courses with 0, 1, 2, and 3 risk factors, respectively (P < 0.001). In conclusion, we identified three pretreatment risk factors associated with SBI in each course of bortezomib treatment. Therefore, MM patients with these risk factors should be more closely monitored for the development of SBI during bortezomib-based treatment.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Shin Young
authors.identifier: 0000-0002-8137-8675
authors.initials: SY
authors.lastname: Hyun
authors.affiliation: Division of Infection, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Han
authors.affiliation: Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Soo-Jeong
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Ji Eun
authors.identifier: 0000-0001-8832-1412
authors.initials: JE
authors.lastname: Jang
authors.affiliation: Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Yundeok
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Hyunsoo
authors.identifier: 0000-0003-2651-6403
authors.initials: H
authors.lastname: Cho
authors.affiliation: Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Jung Yeon
authors.identifier: 0000-0001-6162-5571
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: June-Won
authors.identifier: 0000-0002-1744-0921
authors.initials: JW
authors.lastname: Cheong
authors.affiliation: Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Yoo Hong
authors.identifier: 0000-0001-8542-9583
authors.initials: YH
authors.lastname: Min
authors.affiliation: Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Jae-Woo
authors.identifier: 0000-0002-1877-5731
authors.initials: JW
authors.lastname: Song
authors.affiliation: Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Jin Seok
authors.identifier: 0000-0001-8986-8436
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications* / Q000382:microbiology; D000069286:Bortezomib / Q000008:administration & dosage*; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D018655:Lymphocyte Count; D008231:Lymphopenia / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014184:Transplantation, Homologous
chemical_list: D000069286:Bortezomib
keywords: Bortezomib; Infection; Lymphopenia; Multiple Myeloma; Performance Status