Infectious Complications in Multiple Myeloma under Current Epidemiological Conditions: A Literature Review

IL Davydkin, EV Mordvinova, TP Kuzmina

Samara State Medical University, 89 Chapaevskaya str., Samara, Russian Federation, 443099

For correspondence: Elizaveta Vladimirovna Mordvinova, 89 Chapaevskaya str., Samara, Russian Federation, 443099; Tel.: +7(917)037-52-10, e-mail:

For citation: Davydkin IL, Mordvinova EV, Kuzmina TP. Infectious Complications in Multiple Myeloma under Current Epidemiological Conditions: A Literature Review. Clinical oncohematology. 2021;14(3):386–90. (In Russ).

DOI: 10.21320/2500-2139-2021-14-3-386-390


The review outlines current views on immune system in multiple myeloma (MM) and the basic pathogens inducing infectious complications in such patients. Although in recent years there has been considerable progress in studying molecular mechanisms of the MM development (pathogenesis), methods of its diagnosis, treatment, and prediction of outcomes, one of the main causes of death within this group of patients is infectious complications. In this context, it would be relevant to further study immune disorders and the spectrum of infectious pathogens common in the MM patient cohort. The study and correction of immunological status can contribute to improving the MM outcomes, which in turn will lead to increased life expectancy.

Keywords: multiple myeloma, immunological status, infectious complications, COVID-19.

Received: March 12, 2021

Accepted: June 8, 2021

Read in PDF

Статистика Plumx английский


  1. Davydkin IL, Kuzmina TP, Naumova KV, et al. Endothelial dysfunction in patients with lymphoproliferative disorders and its changes in the course of polychemotherapy. Russ Open Med J. 2020;9(3):309–15. doi: 10.15275/rusomj.2020.0309.
  2. Joshua DE, Bryant C, Dix C, et al. Biology and therapy of multiple myeloma. Med J Aust. 2019;210(8):1–6. doi: 10.5694/mja2.50129.
  3. Smith L, McCourt O, Henrich M, et al. Multiple myeloma and physical activity: a scoping review. BMJ Open. 2015;5(11):1–10. doi: 10.1136/bmjopen-2015-009576.
  4. Злокачественные новообразования в России в 2017 году (заболеваемость и смертность). Под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. М.: МНИОИ им. П.А. Герцена — филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2018.
    [Kaprin AD, Starinskii VV, Petrova GV, eds. Zlokachestvennye novoobrazovaniya v Rossii v 2017 godu (zabolevaemost’ i smertnost’). (Malignant neoplasms in Russia in 2017 (incidence and mortality.) Moscow: MNIOI im. P.A. Gertsena — filial FGBU “NMITs radiologii” Publ.; (In Russ)]
  5. Alemu A, Richards JO, Oaks MK, Thompson MA. Vaccination in Multiple Myeloma: Review of Current Literature. Clin Lymphoma Myel Leuk. 2016;16(9):495–502. doi: 10.1016/j.clml.2016.06.006.
  6. Berlotti P, Pierre A, Rome S, Faiman B. Evidence-based guidelines for preventing and managing side effects of multiple myeloma. Semin Oncol Nurs. 2017;33(3):332–47. doi: 10.1016/j.soncn.2017.05.008.
  7. Teh BW, Slavin MA, Harrison SJ, Worth LJ. Prevention of viral infections in patients with multiple myeloma: the role of antiviral prophylaxis and immunization. Expert Rev Anti-Infect Ther. 2015;13(11):1325–36. doi: 10.1586/14787210.2015.1083858.
  8. Kastritis E, Zagouri F, Symeonidis A, et al. Preserved levels of uninvolved immunoglobulins are independently associated with favorable outcome in patients with symptomatic multiple myeloma. 2014;28(10):2075–9. doi: 10.1038/leu.2014.110.
  9. Mian H, Grant ShJ, Engelhardt M, et al. Caring for older adults with multiple myeloma during the COVID-19 pandemic: Perspective from the International Forum for Optimizing Care of Older Adults with Myeloma. J Geriatr Oncol. 2020;11(5):764–8. doi: 10.1016/j.jgo.2020.04.008.
  10. Brioli A, Klaus M, Sayer H, et al. The risk of infections in multiple myeloma before and after the advent of novel agents: a 12-year survey. Ann 2019;98(3):713–22. doi: 10.1007/s00277-019-03621-1.
  11. Guzdar A, Costello C. Supportive Care in Multiple Myeloma. Curr Hematol Malig Rep. 2020;15(2):56–61. doi: 10.1007/s11899-020-00570-9.
  12. Pratt G, Goodyear O, Moss P. Immunodeficiency and immunotherapy in multiple myeloma. Br J Haematol. 2007;138(5):563–79. doi: 10.1111/j.1365-2141.2007.06705.x.
  13. Teh BW, Harrison SJ, Worth LJ, et al. Infection risk with immunomodulatory and proteasome inhibitor–based therapies across treatment phases for multiple myeloma: A systematic review and meta-analysis. Eur J Cancer. 2016;67:21–37. doi: 10.1016/j.ejca.2016.07.025.
  14. Dhakal B, D’Souza A, Chhabra S, Hari P. Multiple myeloma and COVID-19. Leukemia. 2020;34(7):1961–3. doi: 10.1038/s41375-020-0879-9.
  15. Girmenia C, Cavo M, Offidani M, et al. Management of infectious complications in multiple myeloma patients: Expert panel consensus-based recommendations. Blood Rev. 2019;34:84–94. doi: 10.1016/j.blre.2019.01.001.
  16. Nix EB, Hawdon N, Gravelle S, et al. Risk of invasive Haemophilus influenzae type b (Hib) disease in adults with secondary immunodeficiency in the post-Hib vaccine era. Clin Vacc Immunol. 2012;19(5):766–71. doi: 10.1128/CVI.05675-11.
  17. Blimark, C, Holmberg E, Mellqvist UH, et al. Multiple myeloma and infections: a population-based study on 9253 multiple myeloma patients. Haematologica. 2014;100(1):107–13. doi: 10.3324/haematol.2014.107714.
  18. Truong Q, Veltri L, Kanate AS, et al. Impact of the duration of antiviral prophylaxis on rates of varicella-zoster virus reactivation disease in autologous hematopoietic cell transplantation recipients. Ann Hematol. 2013;93(4):677–82. doi: 10.1007/s00277-013-1913-z.
  19. Teh BW, Worth LJ, Harrison SJ, et al. The timing and clinical predictors of herpesvirus infections in patients with myeloma in the setting of antiviral prophylaxis. Available from: file:///Users/user/Downloads/EV0439.pdf (accessed 13.04.2021).
  20. Teh BW, Worth LJ, Harrison SJ, et al. Risks and burden of viral respiratory tract infections in patients with multiple myeloma in the era of immunomodulatory drugs and bortezomib: experience at an Australian Cancer Hospital. Supp Care Cancer. 2015;23(7):1901–6. doi: 10.1007/s00520-014-2550-3.
  21. Nahi H, Chrobok M, Gran C, et al. Infectious complications and NK cell depletion following daratumumab treatment of multiple myeloma. PLoS One. 2019;14(2):e0211927. doi: 10.1371/journal.pone.0211927.
  22. Bruno G, Saracino A, Monno L, Angarano G. The Revival of an “Old” Marker: CD4/CD8 Ratio. AIDS Rev. 2017;19(2):81–8.
  23. Tramontana AR, George B, Hurt AC, et al. Oseltamivir Resistance in Adult Oncology and Hematology Patients Infected with Pandemic (H1N1) 2009 Virus, Australia. Emerg Infect Dis. 2010;16(7):1068–75. doi: 10.3201/eid1607.091691.
  24. Hirsch HH, Martino R, Ward KN, et al. Fourth European Conference on Infections in Leukaemia (ECIL-4): Guidelines for Diagnosis and Treatment of Human Respiratory Syncytial Virus, Parainfluenza Virus, Metapneumovirus, Rhinovirus, and Coronavirus. Clin Infect Dis. 2012;56(2):258–66. doi: 10.1093/cid/cis844.
  25. Charil A, Samur MK, Martinez-Lopez J, et al. Clinical features associated with COVID-19 outcome in multiple myeloma: first results from the International Myeloma Society data set. 2020;136(26):3033–40. doi: 10.1182/blood.2020008150.
  26. Cook G, Ashcroft AJ, Pratt G, et al. Real-world assessment of the clinical impact of symptomatic infection with severe acute respiratory syndrome coronavirus (COVID-19 disease) in patients with multiple myeloma receiving systemic anti-cancer therapy. Br J Haematol. 2020;190(2):e83–e86. doi: 10.1111/bjh.16874.
  27. Hultcrantz M, Richter J, Rosenbaum C, et al. COVID-19 infections and outcomes in patients with multiple myeloma in New York City: a cohort study from five academic centers. Blood Cancer Discov. 2020;1(3):234–43. doi: 10.1158/2643-3230.bcd-20-0102.
  28. Wang B, Van Oekelen O, Mouhieddine TH, et al. A tertiary center experience of multiple myeloma patients with COVID-19: lessons learned and the path forward. J Hematol Oncol. 2020;13(1):94. doi: 10.1186/s13045-020-00934-x.