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Risk of infections in multiple myeloma. A population-based study on 8,672 multiple myeloma patients diagnosed 2008-2021 from the Swedish Myeloma Registry

Blimark, Cecilie Hveding ; Carlson, Kristina ; Day, Christopher ; Einarsdottir, Sigrun ; Juliusson, Gunnar LU ; Karma, Moshtak ; Knut-Bojanowska, Dorota ; Larfors, Gunnar ; Turesson, Ingemar and Villegas-Scivetti, Mariana , et al. (2025) In Haematologica 110(1). p.163-172
Abstract

In multiple myeloma (MM), advancements in treatments and toxicity management have enhanced survival rates. This, coupled with shifting age demographics in MM, necessitates an updated assessment of infection risks in MM patients compared to the general population. Using Swedish population-based registries, we investigated the incidence of infections in 8,672 Swedish symptomatic MM patients diagnosed 2008-2021 and 34,561 matched controls. Overall, MM patients had a 5-fold risk (hazard ratio [HR] =5.30; 95% confidence interval [CI]: 5.14-5.47) of developing a clinically significant infection compared to matched controls. Bacterial infections represented a 5-fold (HR=4.88; 95% CI: 4.70-5.07) increased risk, viral and fungal infections... (More)

In multiple myeloma (MM), advancements in treatments and toxicity management have enhanced survival rates. This, coupled with shifting age demographics in MM, necessitates an updated assessment of infection risks in MM patients compared to the general population. Using Swedish population-based registries, we investigated the incidence of infections in 8,672 Swedish symptomatic MM patients diagnosed 2008-2021 and 34,561 matched controls. Overall, MM patients had a 5-fold risk (hazard ratio [HR] =5.30; 95% confidence interval [CI]: 5.14-5.47) of developing a clinically significant infection compared to matched controls. Bacterial infections represented a 5-fold (HR=4.88; 95% CI: 4.70-5.07) increased risk, viral and fungal infections 7-fold compared to controls. The first year after MM diagnosis the risk of infections compared to controls was 7-fold (HR=6.95; 95% CI: 6.61-7.30) and remained elevated up to 5 years after the myeloma diagnosis. The risk of infection compared to controls remained 5-fold in MM patients with follow-up till 2022. Preceding MM diagnosis, the risk compared to matched controls was significantly increased up to 4 years before MM diagnosis (HR=1.16; 95% CI: 1.05-1.28). Among MM patients, 8% had died within 2 months of diagnosis and infection contributed to 32% of all deaths. After 1 year, 20% MM patients had died, and infection-related mortality was 27%. Our data constitute the largest population-based study to date on the risk of infections compared to the normal population in the era of modern MM therapies and confirms that infections still represent a major threat to patients and underscores importance of preventive strategies.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Haematologica
volume
110
issue
1
pages
10 pages
publisher
Ferrata Storti Foundation
external identifiers
  • pmid:39021214
  • scopus:85212060804
ISSN
0390-6078
DOI
10.3324/haematol.2024.285645
language
English
LU publication?
yes
id
89c91ca7-9308-494f-9405-8433ee172990
date added to LUP
2025-12-19 13:03:57
date last changed
2025-12-20 03:00:21
@article{89c91ca7-9308-494f-9405-8433ee172990,
  abstract     = {{<p>In multiple myeloma (MM), advancements in treatments and toxicity management have enhanced survival rates. This, coupled with shifting age demographics in MM, necessitates an updated assessment of infection risks in MM patients compared to the general population. Using Swedish population-based registries, we investigated the incidence of infections in 8,672 Swedish symptomatic MM patients diagnosed 2008-2021 and 34,561 matched controls. Overall, MM patients had a 5-fold risk (hazard ratio [HR] =5.30; 95% confidence interval [CI]: 5.14-5.47) of developing a clinically significant infection compared to matched controls. Bacterial infections represented a 5-fold (HR=4.88; 95% CI: 4.70-5.07) increased risk, viral and fungal infections 7-fold compared to controls. The first year after MM diagnosis the risk of infections compared to controls was 7-fold (HR=6.95; 95% CI: 6.61-7.30) and remained elevated up to 5 years after the myeloma diagnosis. The risk of infection compared to controls remained 5-fold in MM patients with follow-up till 2022. Preceding MM diagnosis, the risk compared to matched controls was significantly increased up to 4 years before MM diagnosis (HR=1.16; 95% CI: 1.05-1.28). Among MM patients, 8% had died within 2 months of diagnosis and infection contributed to 32% of all deaths. After 1 year, 20% MM patients had died, and infection-related mortality was 27%. Our data constitute the largest population-based study to date on the risk of infections compared to the normal population in the era of modern MM therapies and confirms that infections still represent a major threat to patients and underscores importance of preventive strategies.</p>}},
  author       = {{Blimark, Cecilie Hveding and Carlson, Kristina and Day, Christopher and Einarsdottir, Sigrun and Juliusson, Gunnar and Karma, Moshtak and Knut-Bojanowska, Dorota and Larfors, Gunnar and Turesson, Ingemar and Villegas-Scivetti, Mariana and Sverrisdóttir, Ingigerdur}},
  issn         = {{0390-6078}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{163--172}},
  publisher    = {{Ferrata Storti Foundation}},
  series       = {{Haematologica}},
  title        = {{Risk of infections in multiple myeloma. A population-based study on 8,672 multiple myeloma patients diagnosed 2008-2021 from the Swedish Myeloma Registry}},
  url          = {{http://dx.doi.org/10.3324/haematol.2024.285645}},
  doi          = {{10.3324/haematol.2024.285645}},
  volume       = {{110}},
  year         = {{2025}},
}