Invasive fungal infections in patients with multiple myeloma: a multi-center study in the era of novel myeloma therapies

Multiple myeloma (MM) is a hematologic malignancy with increasing prevalence in older populations.1 Infections, particularly pyogenic infections and reactivation of latent viral infections,2 are a leading cause of morbidity and mortality in patients with MM. Previously, invasive aspergillosis (IA) had been found to be a significant opportunistic infection in patients with myeloma managed with intensive conventional combination chemotherapeutic regimens with nearly 50% attributable mortality. IA tended to occur early in the treatment course in patients with higher disease stage.3 However, the treatment of myeloma has undergone a paradigm shift with the use of immunomodulatory drugs (IMiDs), proteasome inhibitors (PI) and autologous hematopoietic stem cell transplant (ASCT) as the new standard of care.