The infection rate in new diagnosis and relapsed/refractory multiple myeloma patients who had bortezomib-based chemotherapy and relationship between development of infection and lymphocyte/monocyte ratio

Authors : Merve PAMUKCUOGLU, Nuran Ahu BAYSAL, Mehmet Sezgin PEPELER

Pages : 541-549

Doi:10.18621/eurj.855510

View : 21 | Download : 7

Publication Date : 2021-11-04

Article Type : Research Paper

Abstract :Objectives: Multiple Myeloma insert ignore into journalissuearticles values(MM); is a disease caused by the clonal proliferation of plasma cells. In recent years, proteozom inhibitors, immunomodulatory agents and monoclonal antibodies have been used in the treatment of MM. In this study, the relation of bortezomib, one of the proteozoma inhibitors used in the treatment of MM, with the development of infection was investigated. Methods: We retrospectively evaluated 56 patients who had MM treated with bortezomib-based regimen. We tried to determine the relationship between infection with immunoglobulin G levels at the time of diagnosis, lymphocyte absolute values at the time of diagnosis, lymphocyte absolute values at the time of chemotherapy, neutrophil absolute value at the time of chemotherapy, lymphocyte absolute values at the time of infection, monocyte absolute value at the time of infection, and the lymphocyte/monocyte insert ignore into journalissuearticles values(L/M); ratio at the time of infection. The effects of L/M ratio on progression free survival insert ignore into journalissuearticles values(PFS); and overall survival insert ignore into journalissuearticles values(OS); were also examined. Results: Thirty insert ignore into journalissuearticles values(53.6%); of the 56 patients were newly diagnosed, 26 insert ignore into journalissuearticles values(46.4%); of 56 patients were relapsed/refractory MM. The bortezomib-based regimen was given to all patients. Of the 56 patients included in the study, 21 insert ignore into journalissuearticles values(37.5%); were female, 35 were male insert ignore into journalissuearticles values(62.5%);. The ages of the patients was 28-79 years insert ignore into journalissuearticles values(median: 58.5 years);. No infection attack was observed in 31 insert ignore into journalissuearticles values(55.4%); patients. Disease stage insert ignore into journalissuearticles values(R-ISS); insert ignore into journalissuearticles values(p = 0.032);, presence or absence of co-morbid disease insert ignore into journalissuearticles values(p = 0.035);, disease status during an infection attack insert ignore into journalissuearticles values(p < 0.01);, lymphocytopenia at the time of chemotherapy insert ignore into journalissuearticles values(p = 0.003);, absolute value of lymphocytopenia at the time of infection attack insert ignore into journalissuearticles values(p < 0.01); and L/M ratio insert ignore into journalissuearticles values(p < 0.01); had a significant relation with development of infection. Lymphocytopenia at the time of infection attack insert ignore into journalissuearticles values(p < 0.01, OR<1, 94.6% CI); and L/M ratio insert ignore into journalissuearticles values(p < 0.01, OR<1, 91.1% CI); had been found significant in univariate logistic regression analysis. Lymphocytopenia at the time of infection attack insert ignore into journalissuearticles values(p = 0.002, OR<1, 95% CI); and L/M ratio insert ignore into journalissuearticles values(p = 0.003, OR<1, 95% CI); had been found significant in multivariate logistic regression analysis. L/M ratio had a significant effect on OS insert ignore into journalissuearticles values(p < 0.017); but not on PFS insert ignore into journalissuearticles values(p > 0.05);. Conclusions: It was determined that L/M ratio has an effect on OS and it is also an independent factor on the development of infection. OS was decreasing and the risk of developing infection was increasing, when the L/M ratio was low.
Keywords : bortezomib, infection, lymphocyte monocyte ratio