Bacterial Infection Among Patients With Multiple Myeloma Treated With Bortezomib-based Induction Therapy: Real-World Experience in an Asian Cancer Center
| Autor: | Sanjay de Mel, Melissa Ooi, Wee Joo Chng, Jaslyn Oh, Cinnie Yentia Soekojo, Jia Zhen Low |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Population Renal function Bortezomib 03 medical and health sciences 0302 clinical medicine Levofloxacin Internal medicine Trimethoprim Sulfamethoxazole Drug Combination Humans Medicine 030212 general & internal medicine education Multiple myeloma Aged Retrospective Studies Singapore education.field_of_study business.industry Cancer Bacterial Infections Induction Chemotherapy Hematology Middle Aged medicine.disease Oncology 030220 oncology & carcinogenesis Bacteremia Absolute neutrophil count Female Multiple Myeloma business Fluoroquinolones medicine.drug |
| Zdroj: | Clinical Lymphoma Myeloma and Leukemia. 20:e165-e170 |
| ISSN: | 2152-2650 |
| DOI: | 10.1016/j.clml.2019.12.024 |
| Popis: | Background The treatment landscape for multiple myeloma (MM) has progressed significantly, and over the past decade, bortezomib-based induction therapy has been a standard of care. However, the practice of antibacterial prophylaxis during induction therapy has been diverse. The aim of our study is to evaluate the proportion of patients with febrile episodes and bacteremia among patients with MM, during the first 12 weeks of bortezomib-based induction therapy, without routine fluoroquinolone prophylaxis, but with routine Pneumocystis Carinii prophylaxis (mostly with trimethoprim-sulfamethoxazole), in a region with high fluoroquinolone resistance rate. Of note, these patients have direct access to health care facilities and timely supportive care. Patients and Methods We evaluated newly diagnosed MM patients from 2014 to 2018 receiving bortezomib-based induction therapy for the proportion of patients who had febrile episodes and bacteremia in the first 12 weeks of bortezomib-based induction therapy. We also evaluated if there were factors associated with increased febrile episodes including age, absolute neutrophil count, creatinine clearance, M-band level at diagnosis, nadir platelet count, International Staging System, and Revised International Staging System. Results Of the 108 evaluable patients, there were a total of 25 (23.1%) patients who had febrile episodes, and 1 (0.9%) patient who had bacteremia during the first 12 weeks of bortezomib-based induction therapy. All patients recovered well. No deaths were seen. Febrile episodes were associated with lower absolute neutrophil count (P = .036), renal impairment (P = .013), and ISS stage (P = .026). Conclusion The proportion of patients with significant bacterial infection during the first 12 weeks of bortezomib-based induction therapy without routine fluoroquinolone prophylaxis, but with routine Pneumocystis Carinii prophylaxis (mostly with trimethoprim-sulfamethoxazole), is low in a population with adequate access to health care facilities and timely supportive care. |
| Databáze: | OpenAIRE |
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