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Incidence And Risk Factors for Invasive Fungal Infections in Pre-Transplant and Transplant-Ineligible Multiple Myeloma in the U.S.: A Claims Analysis (2017-2021)

Summary

This study examined fungal infections in patients with multiple myeloma who were not eligible for or preparing for stem cell transplants. Researchers found that 6% of these patients developed invasive fungal infections, with yeast infections being the most common type. The risk of these infections was significantly higher in patients taking dexamethasone (a steroid) or those with low white blood cell counts and those receiving multiple cancer therapies.

Background

Current research on risk factors for invasive fungal infections (IFIs) in multiple myeloma (MM) has limitations due to heterogeneous patient populations including post-transplant patients or reliance on subgroup analyses. This study aimed to address this gap by evaluating the incidence of IFIs and identifying risk factors in patients with MM receiving treatment before or ineligible for transplant.

Objective

To evaluate the incidence and identify risk factors for invasive fungal infections in patients with multiple myeloma who are receiving anti-MM therapy before transplant or are transplant-ineligible.

Results

Among 3054 individuals with MM, 6% (n=195) were diagnosed with an IFI, with candidiasis being most common (87%), followed by pneumocystis (6.2%) and aspergillosis (3.6%). Multivariate analysis identified recent dexamethasone use (HR 5.85), neutropenia (HR 2.77), and greater number of anti-MM therapies within the preceding year (HR 2.15) as significant risk factors for IFI.

Conclusion

Candidiasis was the most common IFI in patients with MM. Younger age, higher comorbidity burden, and neutropenia were associated with IFIs, while recent dexamethasone use and a higher number of prior anti-MM therapies significantly increased the risk of IFIs.
  • Published in:Open Forum Infectious Diseases,
  • Study Type:Claims Analysis,
  • Source: 10.1093/ofid/ofae631.1209, PMC11777601
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