Low frequency of CD3(+)CD4(+)CD161(+) T cells correlates with the occurrence of infections in refractory/relapsed multiple myeloma patients receiving lenalidomide plus low-dose dexamethasone treatment

摘要

The aim of this study was to explore the predictive implications of the composition of immune cell populations prior to lenalidomide plus high-dose dexamethasone (Len-Dex) initiation for the occurrence of infections. We prospectively examined immune cell populations in peripheral blood taken at baseline of lenalidomide plus low-dose dexamethasone (Len-dex) therapy and reviewed clinical and microbiology records in 90 patients with refractory/relapsed multiple myeloma (RRMM). Risk factors for infection were analyzed using logistic regression. During a median of 11cycles of Len-dex treatment, 52 (57.8%) patients experienced at least 1 infection episode. Of a total of 92 episodes of infection, 58 (63%) episodes were clinically defined, 29 (31.5%) episodes were microbiologically defined, and 5 (5.4%) episodes were fever of unknown origin. Severe episodes were more frequently observed during the first 3cycles. After adjusting for risk factors for infection based on univariate analyses, multivariate analyses showed that lower Hb (10g/dL) was a clinically independent factor associated with occurrence of infections. Lower frequency (P=0.044) and absolute count (P=0.014) of circulating CD3(+)CD4(+)CD161(+) cells prior to Len-dex treatment were also associated with the occurrence of infection, especially during the first 3cycles of Len-dex therapy. In addition to several clinical predictive factors, we found that CD3(+)CD4(+)CD161(+) cells may provide additional information for predicting the occurrence of infection in the early period of Len-dex therapy.