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Annals of Hematology

, Volume 97, Issue 11, pp 2163–2171 | Cite as

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

  • Sung-Eun Lee
  • Ji-Young Lim
  • Da-Bin Ryu
  • Tae Woo Kim
  • Sung Soo Park
  • Young-Woo Jeon
  • Jae-Ho Yoon
  • Byung-Sik Cho
  • Ki-Seong Eom
  • Yoo-Jin Kim
  • Hee-Je Kim
  • Seok Lee
  • Seok-Goo Cho
  • Dong-Wook Kim
  • Jong Wook Lee
  • Chang-Ki MinEmail author
Original Article

Abstract

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 11 cycles 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 3 cycles. After adjusting for risk factors for infection based on univariate analyses, multivariate analyses showed that lower Hb (< 10 g/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 3 cycles 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.

Keywords

Multiple myeloma Lenalidomide Low-dose dexamethasone Infection CD4+CD161+ T cells 

Notes

Acknowledgements

This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (#HI16C0047).

Compliance with ethical standards

Written informed consent was obtained from each patient before participation in this study. This study was approved by the Institutional Review Board of the Catholic University of Korea and was conducted in accordance with the Declaration of Helsinki.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

277_2018_3401_MOESM1_ESM.docx (18 kb)
ESM 1 (DOCX 17.7 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Sung-Eun Lee
    • 1
  • Ji-Young Lim
    • 1
  • Da-Bin Ryu
    • 1
  • Tae Woo Kim
    • 1
  • Sung Soo Park
    • 1
  • Young-Woo Jeon
    • 1
  • Jae-Ho Yoon
    • 1
  • Byung-Sik Cho
    • 1
    • 2
  • Ki-Seong Eom
    • 1
    • 2
  • Yoo-Jin Kim
    • 1
    • 2
  • Hee-Je Kim
    • 1
    • 2
  • Seok Lee
    • 1
    • 2
  • Seok-Goo Cho
    • 1
  • Dong-Wook Kim
    • 1
    • 2
  • Jong Wook Lee
    • 1
  • Chang-Ki Min
    • 1
    • 2
    Email author
  1. 1.Department of Hematology, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
  2. 2.Catholic Leukemia Research InstituteThe Catholic University of KoreaSeoulSouth Korea

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