Infectious complications during programmed therapy for multiple myeloma

Introduction. Monitoring infectious complications during the programmed therapy of hematological malignancies remains a critical issue in modern hematology. Aim. To examine the frequency and nature of infectious complications in patients with multiple myeloma (MM) treated at the Irkutsk Regional Clinical Hospital from 2016 to 2023. Materials and methods. A total of 450 medical records of MM patients who underwent programmed chemotherapy (CT) from 2016 to 2023 were analyzed. Among these, 213 patients (47%) were diagnosed with various infectious complications. These patients were divided into two groups: Group 1 consisted of 100 patients who received CT from 2016 to 2019, while Group 2 included 113 patients treated from 2020 to 2023. Results. The most common infectious complications associated with MM were bacterial pneumonia (41% in 2016-2019 and 18% in 2020-2023), fever of unknown origin (20% in 2016-2019 and 22% in 2020-2023), urinary tract infections (20% in 2016-2019 and 8.8% in 2020-2023), cytomegalovirus (CMV) infection (9% in 2016-2019 and 18.5% in 2020-2023), and in 2020-2023, the emergence of novel coronavirus infection (observed in 17% of MM patients). The majority of infectious complications occurred during the remission induction phase. A significant decrease in bacterial pneumonia (p<0.001) and urinary tract infections (p=0.020) was observed in 2020-2023 compared to 2016-2019, while an increase in CMV infection was noted (p=0.045). Other infectious complications, including gastrointestinal infections, mucositis, herpes infections, and skin and ENT infections, were infrequently reported during the study period. Conclusion. The study revealed new data that can be used to predict the development of infectious complications at various stages of programmed therapy for MM and to formulate effective preventive measures in clinical practice.