Invasive aspergillosis in patients with multiple myeloma: clinical case report and a multi-center study results

In multicenter study (1998-2017) we included 46 adult patients with multiple myeloma (MM) and invasive aspergillosis (IA), which is 7% of the adult oncohematological cohort of patients with IA. The median age of patients with MM and IA is 55 years (26-79), female - 59%. In the comparison group we included 18 patients with MM, similar in gender and age. All of them had an infectious syndrome with lung damage, but IA diagnosis was excluded. It was found that in 54% of patients, IA developed in patients with debut of MM or refractory disease. Patients with stage III MM according to B.Durie, S.Salmon prevailed (86%). Risk factors for the development of IA were: uncontrolled MM (34% vs. 5%, p=0.001), prolonged lymphocytopenia (56% vs. 26%, p=0.01) and allo-HSCT (11% vs. 0%, p=0.01). Severe bacterial infection before the IA development in 33% of cases was noted. Lungs involvement was observed in 100% of patients. The main causative agents of IA were:A. niger (43%) and A. fumigatus (38%). All patients received antifungal therapy (voriconazole - 87%). The overall 12-week survival of patients with MM and IA was 93%