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Risk and impact of invasive fungal infections in patients with multiple myeloma.
Tsai, Chun-Kuang; Liu, Yao-Chung; Kuan, Ai Seon; Lee, Kang-Lung; Yeh, Chiu-Mei; Lee, Yu-Ting; Hsiao, Liang-Tsai; Ko, Po-Shen; Wang, Hao-Yuan; Chen, Po-Min; Liu, Jin-Hwang; Hong, Ying-Chung; Liu, Chia-Jen; Gau, Jyh-Pyng.
Afiliación
  • Tsai CK; Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.
  • Liu YC; Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.
  • Kuan AS; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
  • Lee KL; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
  • Yeh CM; Division of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Lee YT; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
  • Hsiao LT; Department of Radiology, Taipei Veterans General Hospital, Taipei City, Taiwan.
  • Ko PS; Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.
  • Wang HY; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
  • Chen PM; Division of Hematology and Oncology, Department of Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan.
  • Liu JH; Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.
  • Hong YC; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
  • Liu CJ; Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.
  • Gau JP; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Ann Hematol ; 99(8): 1813-1822, 2020 Aug.
Article en En | MEDLINE | ID: mdl-32607596
Infection is associated with great morbidity and mortality in patients with multiple myeloma (MM), but evidence for invasive fungal infections (IFIs) is lacking. We aimed to investigate risk factors for IFI in MM patients and to determine its impact on patients' survival. We retrospectively analyzed MM patients at Taipei Veterans General Hospital in Taiwan between January 2002 and October 2018. MM was diagnosed according to the International Myeloma Working Group criteria. IFI was defined according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. All risk factors of IFI in MM patients were estimated using Cox regression models in the univariate and multivariate analyses. Of the 623 patients recruited, 22 (3.5%) were diagnosed with proven or probable IFI. Light chain disease (adjusted hazard ratio [HR] 6.74, 95% confidence interval [CI] 2.10-21.66), hemoglobin less than 8 g/dl (adjusted HR 3.34, 95% CI 1.32-8.42), serum albumin < 3.5 g/dl (adjusted HR 3.24, 95% CI 1.09-9.68), and having received allogeneic stem cell transplantation (allo-SCT) (adjusted HR 5.98, 95% CI 1.62-22.03) were significantly associated with IFI in the multivariate analysis. Contracting IFI was in turn associated with early mortality (adjusted HR 11.60, 95% CI 1.26-106.74). Light chain disease, anemia, hypoalbuminemia, and receiving allo-SCT were independent predictors of IFI in MM patients. The early mortality risk is much higher in those encountering IFI. Physicians must be aware of the rare but potentially lethal infections.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Células Madre / Infecciones Fúngicas Invasoras / Mieloma Múltiple Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Hematol Asunto de la revista: HEMATOLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Células Madre / Infecciones Fúngicas Invasoras / Mieloma Múltiple Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Hematol Asunto de la revista: HEMATOLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Alemania