In multiple myeloma (MM), advancements in treatments and toxicity management have enhanced survival rates. This, coupled with shifting age demographics in MM, necessitates an updated understanding of infection risks in MM patients compared to the general population. Using Swedish population-based registries, we investigated the incidence of infections in 8,672 Swedish symptomatic MM patients diagnosed 2008-2021 and 34,561 matched controls. Overall, MM patients had a 5-fold risk (hazard ratio (HR) = 5.30; 95%, Confidence Interval = CI 5.14-5.47) of developing any clinically significant infection compared to matched controls. Bacterial infections represented a 5-fold (HR 4.88; CI 4.70-5.07) increased risk, viral and fungal infections 7-fold compared to controls. The 1st year after MM diagnosis the risk of infections compared to controls was 7 -fold (HR 6.95; CI 6.61-7.30) and remained elevated up to 5 years after the myeloma diagnosis. The risk of infection compared to controls remained 5-fold in MM patients with follow-up till 2022. Preceding MM diagnosis, the risk compared to matched controls was significantly increased up to four years before MM diagnosis (HR1.16; CI 1.05-1.28). Among MM patients, 8% had died within 2 months of diagnosis and infection contributed to 32% of all deaths. After 1 year, 20% MM patients had died, and infection-related mortality was 27%. Our data constitute the largest population-based study to date on the risk of infections compared to the normal population in the era of modern MM therapies and confirms that infections still represent a major threat to patients and underscores importance of preventive strategies.

中文翻译：

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多发性骨髓瘤的感染风险。一项针对 8672 名 2008-2021 年从瑞典骨髓瘤登记处诊断的多发性骨髓瘤患者的人群研究。


在多发性骨髓瘤 （MM） 中，治疗和毒性管理的进步提高了生存率。这一点，再加上 MM 年龄人口结构的变化，需要对 MM 患者与普通人群相比的感染风险有新的了解。使用瑞典基于人群的登记处，我们调查了 8,672 名 2008-2021 年诊断的瑞典有症状 MM 患者的感染率和 34,561 名匹配的对照。总体而言，与匹配的对照组相比，MM 患者发生任何临床显着感染的风险是 5 倍 （风险比 （HR） = 5.30;95%，置信区间 = CI 5.14-5.47）。细菌感染占 5 倍 （HR 4.88;CI 4.70-5.07） 风险增加，病毒和真菌感染比对照组增加 7 倍。MM 诊断后第 1 年，与对照组相比，感染风险是 7 倍 （HR 6.95;CI 6.61-7.30），并且在骨髓瘤诊断后长达 5 年内保持升高。截至 2022 年，随访的 MM 患者感染风险仍是对照组的 5 倍。先前的 MM 诊断，与匹配的对照相比，在 MM 诊断前四年内，风险显著增加 （HR1.16;CI 1.05-1.28）。在 MM 患者中，8% 在诊断后 2 个月内死亡，感染占所有死亡的 32%。1 年后，20% 的 MM 患者死亡，感染相关死亡率为 27%。我们的数据构成了迄今为止最大的基于人群的基于人群的研究，与现代 MM 治疗时代的正常人群相比，感染风险并证实感染仍然对患者构成主要威胁，并强调了预防策略的重要性。