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01-06-2018 | Review Article

Immunomodulatory drugs and the risk of serious infection in multiple myeloma: systematic review and meta-analysis of randomized and observational studies

Authors: Min Chen, Yongfeng Zhao, Chuanxin Xu, Xian Wang, Xianping Zhang, Benyu Mao

Published in: Annals of Hematology | Issue 6/2018

Abstract

The effect of immunomodulatory drugs (IMiDs) on serious infection remains uncertain. We therefore conducted a systematic review and meta-analysis to assess the possible impact of IMiDs on serious infection in patients with multiple myeloma (MM). We searched randomized controlled trials (RCTs) and observational studies from databases that addressed the effect of IMiDs on serious infection in patients with MM. We pooled data from RCTs and observational studies separately and used the GRADE approach to rate the quality of evidence. Rates in patients with individual IMiDs at different treatment status ranged from 7.00 to 23.00%. The use of thalidomide- or lenalidomide-based regimen induction therapy for autologous stem cell transplantation (ASCT)-ineligible patients suggests increase in serious infection (RR = 1.59, 95% CI 1.31–1.93, p < 0.01). Compared to conventional therapy, IMiDs’ induction in ASCT-eligible patients significantly decreases the risk of serious infection (RR = 0.82, 95% CI 0.72–0.94, p < 0.01). Lenalidomide-based therapy was associated with a significant increase in risk of serious infection in patients treated compared with conventional therapy (RR = 2.45, 95% CI 1.57–3.83, p < 0.01). The current evidence suggests that patients with MM treated with IMiDs are at a high risk of serious infection.

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Title: Immunomodulatory drugs and the risk of serious infection in multiple myeloma: systematic review and meta-analysis of randomized and observational studies
Authors: Min Chen
Yongfeng Zhao
Chuanxin Xu
Xian Wang
Xianping Zhang
Benyu Mao
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: Annals of Hematology / Issue 6/2018
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-018-3284-y

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Immunomodulatory drugs and the risk of serious infection in multiple myeloma: systematic review and meta-analysis of randomized and observational studies

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Concurrent mucosa-associated lymphoid tissue lymphoma with diffuse large B-cell lymphoma transformation and Hodgkin lymphoma of the neck

Prognostic meaning of neutrophil to lymphocyte ratio (NLR) and lymphocyte to monocyte ration (LMR) in newly diagnosed Hodgkin lymphoma patients treated upfront with a PET-2 based strategy

An update on classification, genetics, and clinical approach to mixed phenotype acute leukemia (MPAL)

Mutational analysis aids the diagnosis of primary myelofibrosis with atypical morphology

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page