Consensus guidelines and recommendations for infection prevention in multiple myeloma: a report from the International Myeloma Working Group

Noopur S Raje; Elias Anaissie; Shaji K Kumar; Sagar Lonial; Thomas Martin; Morie A Gertz; Amrita Krishnan; Parameswaran Hari; Heinz Ludwig; Elizabeth O'Donnell; Andrew Yee; Jonathan L Kaufman; Adam D Cohen; Laurent Garderet; Ashutosh F Wechalekar; Evangelos Terpos; Navin Khatry; Ruben Niesvizky; Qing Yi; Douglas E Joshua; Tapan Saikia; Nelson Leung; Monika Engelhardt; Mohamad Mothy; Andrew Branagan; Ajai Chari; Anthony J Reiman; Brea Lipe; Joshua Richter; S Vincent Rajkumar; Jesús San Miguel; Kenneth C Anderson; Edward A Stadtmauer; Rao H Prabhala; Phillip L McCarthy; Nikhil C Munshi

doi:10.1016/S2352-3026(21)00283-0

Consensus guidelines and recommendations for infection prevention in multiple myeloma: a report from the International Myeloma Working Group

Lancet Haematol. 2022 Feb;9(2):e143-e161. doi: 10.1016/S2352-3026(21)00283-0.

Authors

Noopur S Raje¹, Elias Anaissie², Shaji K Kumar³, Sagar Lonial⁴, Thomas Martin⁵, Morie A Gertz³, Amrita Krishnan⁶, Parameswaran Hari⁷, Heinz Ludwig⁸, Elizabeth O'Donnell⁹, Andrew Yee⁹, Jonathan L Kaufman⁴, Adam D Cohen¹⁰, Laurent Garderet¹¹, Ashutosh F Wechalekar¹², Evangelos Terpos¹³, Navin Khatry¹⁴, Ruben Niesvizky¹⁵, Qing Yi¹⁶, Douglas E Joshua¹⁷, Tapan Saikia¹⁸, Nelson Leung³, Monika Engelhardt¹⁹, Mohamad Mothy²⁰, Andrew Branagan⁹, Ajai Chari²¹, Anthony J Reiman²², Brea Lipe²³, Joshua Richter²¹, S Vincent Rajkumar³, Jesús San Miguel²⁴, Kenneth C Anderson²⁵, Edward A Stadtmauer¹⁰, Rao H Prabhala²⁵, Phillip L McCarthy²⁶, Nikhil C Munshi²⁵

Affiliations

¹ Center for Multiple Myeloma, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA. Electronic address: nraje@mgh.harvard.edu.
² CTI Clinical Trial and Consulting Services, Cincinnati, OH, USA.
³ Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
⁴ Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA.
⁵ UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.
⁶ Judy and Bernard Briskin Myeloma Center, City of Hope, Duarte, CA, USA.
⁷ Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
⁸ Wilhelminen Cancer Research Institute, First Department of Medicine, Clinic Ottakring, Vienna, Austria.
⁹ Center for Multiple Myeloma, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
¹⁰ Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
¹¹ Service d'Hématologie et thérapie cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.
¹² National Amyloidosis Centre, University College London, London, UK.
¹³ Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece.
¹⁴ Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India; Homi Bhabha National Institute, Mumbai, India.
¹⁵ Division of Hematology and Oncology, Weill Cornell Medicine, New York, NY, USA.
¹⁶ Cancer Center Basic Research Programs, Houston Methodist Research Institute, Houston, TX, USA.
¹⁷ Institute of Haematology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
¹⁸ Bone Marrow Transplantation and Medical Oncology Department, Prince Aly Khan Hospital, Mumbai, India.
¹⁹ Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany.
²⁰ Hematology Department, Hôpital Saint-Antoine, AP-HP, Paris, France.
²¹ Department of Medicine, Hematology, and Medical Oncology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
²² Department of Oncology, Saint John Regional Hospital, Saint John, NB, Canada.
²³ Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
²⁴ Clínica Universidad de Navarra, Centro de Investigación Médica Aplicada, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain.
²⁵ Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
²⁶ Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.

PMID: 35114152
DOI: 10.1016/S2352-3026(21)00283-0

Abstract

Infection remains the leading cause of morbidity and mortality in patients with multiple myeloma because of the cumulative effect of disease, treatment, and host-related factors. Given that infectious risk is cumulative through the course of the disease, preventing infections is paramount. Optimal preventive strategies include vaccination against common pathogens, antimicrobial prophylaxis, infection control measures, and immunoglobulin replacement in a small subset of patients; however, there are no universally accepted guidelines for infection prevention. This Review provides a consensus statement from a panel of 36 experts with global representation, which was convened by The International Myeloma Society to review existing literature and current guidelines, address issues associated with the risk of infection and prevention of infectious complications in multiple myeloma in the context of emerging therapies, and offer recommendations for preventing these complications.

Publication types

Review

MeSH terms

Consensus
Humans
Infections* / complications
Multiple Myeloma* / complications
Multiple Myeloma* / drug therapy