Infection Analysis Of Multiple Myeloma After Chemotherapy And Its Correlation With Cellular Immune Function

Background Multiple myeloma(MM)is the second most common malignant tumor in the blood system,and most frequently occurs in elderly patients.With the deepening understanding of the pathogenesis of MM,the updating of diagnostic criteria and prognostic assessment methods,and the advent of new drugs,the survival of MM patients has been significantly improved.However,MM is still a disease that cannot be completely cured.As the survival time of MM patients is prolonged,it is particularly important to manage the complications of the disease and its treatment.Infection is the main cause of complications and death in MM patients,and early death in some patients is caused by infection.Therefore,it is very important to know the risk factors and characteristics of MM infection and to prevent and cure infection.Immune deficiency in multiple myeloma is an important factor in susceptibility to infection.Cells involved in immune regulation include adaptive immune cells(T lymphocytes and their subsets,B lymphocytes,etc.)and innate immune cells(natural killer cells,NKT cells,dendritic cells,monocytes/macrophages,granulocytes,and mast cells,etc.).At present,there are many studies on the changes and functions of different immune cells in different diseases,but few studies on the co-infection of different immune cells and MM patients.Objective By analyzing the risk factors and characteristics of post-chemotherapy infection in MM patients and studying the correlation between cellular immune function and infection,this paper provides guidance for clinical work,so as to achieve the goal of early prevention and early treatment of MM infection complications,improve the prognosis of patients and find out new risk predictors of infection.Methods This thesis is divided into two parts.The first part: Retrospective analysis of clinical data of MM patients who were hospitalized from February 1,2015 to December 31,2019.Patients who meet the eligibility criteria are classified as infected according to whether they are infected.Group and non-infected group,analyze the characteristics of infection and use statistical methods to analyze the risk factors of nosocomial infection.Part 2: Collect peripheral blood samples of eligible patients admitted to hospital between December 1,2017 and December 31,2019 for cellular immune function testing,and divide them into infected and non-infected groups according to whether they are infected.Use statistics Analysis of the correlation between cellular immune function and infection.Results part one :1.A total of 52 of the 92 patients were infected,with 40 uninfected patients,and the incidence of infection was 56.52%(52/92).2.Long hospital stay(P=0.000),reduced Neut(P=0.037),low Hb(P=0.016),and low ALB(P=0.013)were independent risk factors for infection after MM chemotherapy.3.The incidence of infection was 64.18%(43/67)of respiratory tract infection,14.93%(10/67)of urinary tract infection,7.46%(5/67)of intestinal tract infection,5.97%(4/67)of skin infection,4.48%(3/67)of blood stream infection,and 1.49%(1/67)of abdominal and perianal infection.4.Bacteria,fungi and viruses were the main infectious pathogens,among which bacterial infection was the most common,with an infection rate of 89.55%(60/67).The incidence of fungal infection was 7.46%(5/67),and the incidence of cutaneous herpes virus infection was 2.99%(2/67).Part 2:1.Among 167 patients whose cellular immune function was tested,68 developed infection,while 99 did not,with an infection rate of 40/72%(68/167).2.In the infected group,T%,CD4+T%,CD8+T%,TEF and TREG/TEF decreased compared with the non-infected group.The differences of T%,CD8+T% and TEF were statistically significant(p < 0.05).3.The levels of CD4+T/CD8+T,B%,NK% and TREG in the infected group were higher than those in the non-infected group.Among them,NK% and TREG showed statistically significant difference(p < 0.05).Conclusion The incidence of MM infection is high,the main infection sites are mainly pulmonary infection,and the pathogens of infection are mostly bacterial infection.Long hospital stay,reduced Neut,low Hb and low ALB are independent risk factors for infection after MM chemotherapy.In MM patients,cellular immune function was deficient,and T%,CD8+T%,TEF decreased,NK% and TREG increased,which were associated with infection.This study can provide guidance for clinical prevention and treatment of MM concurrent infection,and cellular immune function may become a new predictive risk indicator for MM concurrent infection.