Impact of novel agent therapies on immune cell subsets and infectious complications in patients with relapsed/refractory multiple myeloma

Frontiers in Oncology

Oncology

Katharina Kriegsmann¹  Dorothee Kaudewitz¹  Nicola Giesen¹  Michael Hundemer¹  Elias K. Mai¹  Lukas John²  Marc S. Raab²  Karin Jordan³  Hartmut Goldschmidt⁴  Carsten Müller-Tidow⁴  Kaya Miah⁵  Axel Benner⁵ 

[1] Department of Medicine V - Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany;Department of Medicine V - Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany;Clinical Cooperation Unit Molecular Hematology/Oncology, Department of Internal Medicine V, Heidelberg University Hospital, and German Cancer Research Center (DKFZ), Heidelberg, Germany;Department of Medicine V - Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany;Department of Hematology, Oncology and Palliative Medicine, Ernst von Bergmann Hospital, Potsdam, Germany;Department of Medicine V - Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany;National Center for Tumor Diseases (NCT), Heidelberg, Germany;Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany;

关键词: CD4+-T-cells;    infections;    relapsed refractory multiple myeloma;    novel agents;    immune cell subsets;   

DOI  :  10.3389/fonc.2023.1078725

 received in 2022-10-24, accepted in 2023-03-30,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionInfections are a leading cause of morbidity and mortality in patients with multiple myeloma (MM). MethodsTo examine the effects of modern second-generation novel agent therapy on immune cell subsets, in particular CD4+-T-cells, and infectious complications in patients with relapsed/refractory MM (RRMM), we conducted a prospective cohort study in 112 RRMM patients. ResultsSubstantially decreased CD4+-T-cells <200/µl before initiation of relapse therapy were detected in 27.7% of patients and were associated with a higher number of previous lines of therapy. Relapse therapy with carfilzomib or pomalidomide showed a significant further decrease of CD4+-T-cells. All novel agents led to a significant decrease of B-cell counts. Overall, infections were frequent with 21.3% of patients requiring antibacterial therapy within the first 3 months of relapse therapy, 5.6% requiring hospitalization. However, in the setting of standard antimicrobial prophylaxis in RRMM patients with very low CD4+-T-cells, no significant association of CD4+T-cell count and an increased risk of infection could be detected. DiscussionOur findings imply that reduced CD4+-T-cell numbers and infections are common in patients with RRMM. We also demonstrate an association with the number of previous therapies and certain substances suggesting an increased need for personalized prophylaxis strategies for opportunistic infections in this patient cohort.

【 授权许可】

Unknown   
Copyright © 2023 John, Miah, Benner, Mai, Kriegsmann, Hundemer, Kaudewitz, Müller-Tidow, Jordan, Goldschmidt, Raab and Giesen