Invasive Pulmonary Aspergillosis in Multiple Myeloma patients: a sizeable diagnosis in the era of novel anti-myeloma therapies

Mycoses. 2021 Jun 26. doi: 10.1111/myc.13344. Online ahead of print.


BACKGROUND: Advances in treatment for Multiple Myeloma (MM) patients entails a high risk for opportunistic infections such as Invasive pulmonary aspergillosis (IPA).

OBJECTIVES: This study was conducted in order to describe the patient’s profile, clinical manifestations, diagnosis and outcome of MM patients with IPA, in our large haemato-oncology center.

PATIENTS/METHODS: We retrospectively analyzed patients with MM underwent Broncho alveolar lavage for pneumonia at Rambam Hospital during a 13-year period from July 2005 to February 2018. We focused on those with Aspergillus pneumonia.

RESULTS: Of the 669 patients with Multiple Myeloma, mean age 62.6 (±7.6) years, forty-two patients (6.2%) were diagnosed with IPA. Among them 60% had a probable diagnosis and 40% possible. Clinical presentation was similar for IPA and other pulmonary infections. Compared to those with other pulmonary infections, IPA was more commonly diagnosed in patients with long standing disease (P = 0.00012) and among patients receiving 3 or more lines of myeloma therapies (p=0.04). 30-day mortality rates following diagnostic bronchoscopy did not differ between IPA and non-IPA patients. (p=0.85).

CONCLUSIONS: MM patients had an increased risk for IPA, most notably in patients with 3 or more lines of anti-myeloma treatment and more advanced disease. This clearly emphasize the vigilance needed for IPA in these patients.

PMID:34173984 | DOI:10.1111/myc.13344

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