Infection risk with new myeloma agents
Proteosome inhibitors (PIs) and multiple lines of therapy are associated with a higher risk of infections in patients with multiple myeloma (MM).
A Melbourne study identified 345 infections in a cohort of 148 patients with MM treated with second-generation therapies and/or monoclonal antibodies between January 2013 and December 2018.
The median time to a first infection was three months from commencement of a new general MM therapy and 60% of infections occurred within12 months.
Viral infections (14.5%) such as RSV, rhinovirus and influenza were the most common group of microbiologically defined infections followed by bacterial infections (13.0%) such as E. coli, H. influenza and C. difficile.
More than half (58.0%) of viral MDIs were associated with a hospital admission.
The study found the use of PI-based therapy (OR 16.80), a combination of IMiD and PI therapy (OR 13.44), mAbs in combination with IMiD and/or PI therapy (OR 10.44), and more than four lines of therapy (OR 7.72) were significantly and independently associated with an increased risk of infection.
“In patients with relapsed or refractory disease, preventative measures targeting viral infections and patients at higher risk require further evaluation,” the study concluded.
In-person component to ISTH 2021 ditched
The International Society on Thrombosis and Haemostasis (ISTH) is the latest to announce a move to an all-virtual format for their XXIX Congress due to “remaining uncertainty” and continued restrictions on international travel and gatherings.
“After accounting for the safety of our international members, attendees, staff, exhibitors and sponsors, we believe this is the most responsible option in the midst of a global public health crisis,” said ISTH President Dr Jeffrey Weitz.
The ISTH had planned a hybrid Congress with an on-site option taking place in Philadelphia, Pennsylvania.
However a worrying surge in COVID-19 cases over recent weeks includes the northeastern part of the US. Pennsylvania’s seven-day average for new COVID-19 cases has risen from about 2,500 in early March to over 4,000 a month later.
“The ISTH Council and Local Organising Committee are disappointed that we will not be able to bring our international colleagues together in person this year, but we believe that as healthcare professionals, we have a particular responsibility to make global public health aspects our main concern,” Dr Weitz said.
The now all-virtual Congress will include special sessions dedicated to COVID-19 and thrombosis.
Multicultural community raises need to screen for infection
Researchers have called for universal screening for latent and undiagnosed infections among overseas-born patients with cancer.
An audit of 952 overseas-born patients presenting at the Peter MacCallum Cancer Centre in 2019 found only about half were screened for hepatitis B (58.9%) and hepatitis C infections (50.7%). Fewer patients were screened for HIV (30.5%) and latent TB (18.3%) infections.
The study found that even among epidemiologically high-risk patients, 35% were not screened for any infection before commencing cancer therapy.
“If patients were screened according to epidemiological risk, 10% (N = 8) of HBV positive patients would have been missed, and 11% (N = 4) of patients with LTBI,” the study said.
Patients with haematological malignancies were more likely to be screened than those with solid cancers.
“Our data demonstrate the need for a comprehensive and accessible screening protocol for latent infections prior to cancer therapy, especially for cancer patients born outside of Australia,” the researchers said.