Recurrent infection
Myeloma patients have a much greater risk of infection than normal healthy individuals. This may be due to:
- Inhibition of haematopoietic stems cells and/or white blood cell precursors in the bone marrow by cytokines produced by myeloma cells, preventing white blood cell production
- Inadequate production of functional antibodies and subsequent impairment of the immune response to infection
- Treatment with immunosuppressive drugs, such as steroids, that can exacerbate existing immune deficiency
- Newer cellular therapies such as bispecific antibodies and the immunosuppression caused by treatment of side effects such as cytokine release syndrome
Infection is the biggest single cause of early mortality in myeloma patients: a quarter of patients will have a serious infection within three months of diagnosis and infection accounts for almost half of early deaths following a myeloma diagnosis.
It is important to be aware that myeloma patients have an increased susceptibility to infection. Vigilance of both healthcare professionals and patients themselves in identifying signs of and symptoms of infection is vital in reducing the high mortality seen in patients at diagnosis. Infection will be discussed in more detail in Module 8.