ASH 2025 | Incidence and risk factors for infections in NDMM treated with modern induction regimens

So in this study we saw the incidence and risk factors for infections in newly diagnosed patients with myeloma who were treated in the past five years with modern regimens including triplets and quadruplets with anti-CD38 monoclonal antibodies. As probably you know, infection is one of the major complications of myeloma and is also associated with significant morbidity and mortality among patients. So we evaluated a few hundred patients, about 500 patients, for the incidence of infections in the first 12 months from the start of induction therapy. What is interesting is that we identified some risk factors associated with a higher risk, especially for grade 3 or higher infections, the more severe infections, including the age, the degree of renal dysfunction, and the performance status of the patients. And we could identify a subgroup of patients with a significant risk of severe infections. Importantly, the infections were more prevalent during the first three to four months after the start of treatment. What is also very important is that the most modern efficacious regimens, at least in the short term, did not seem to increase the risk of severe infections. Maybe they do that in the long term, but in the short term, they don’t seem to increase the risk of infections. It is very important also to note here that the patients in this study did not receive prophylactic IVIG, but they received some prophylactic antibiotics, mostly Bactrim and Valacyclovir.

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