TUESDAY, Dec. 19, 2023 (HealthDay News) — A robust score can identify patients with newly diagnosed multiple myeloma (NDMM) at risk for severe infection/death, according to a study published online Dec. 7 in Leukemia.

Elias K. Mai, M.D., from the University Hospital Heidelberg in Germany, and colleagues examined 3,700 transplant-eligible NDMM patients treated in 2005 to 2020 with novel agent-based triplet/quadruplet induction therapy (IT). The patients were categorized into a training cohort (1,333 patients) and three validation cohorts (2,367 patients).

The researchers found that 11.8, 1.8, and 12.5 percent of patients in the training cohort experienced severe infections, death, or both, respectively, during IT. Low platelet count (<150 n/L), International Staging System III, higher World Health Organization performance status (>1), and age (older than 60 years) were identified as major baseline risk factors for severe infection/death. In the low- versus intermediate- versus high-risk groups, the risk for severe infection increased from 7.7 to 11.5 to 23.3 percent, respectively. In three trials incorporating quadruplet IT with an anti-CD38 antibody, the risk score was independently validated.

“Our study highlights the importance of early severe infections and death in the era of novel agent-based therapy in patients with NDMM,” the authors write. “Based on our risk score, patients at high risk of early, severe infections and death can be easily identified upfront, when evaluated for the latest quadruplet induction therapies including an anti-CD38 monoclonal antibody.”

Several authors disclosed ties to the biopharmaceutical industry, including several companies that funded the trials.

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