Chemotherapy-related infections in patients with multiple myeloma: associations with mannan-binding lectin genotypes

: Objectives: To study a possible association between mannan‐binding lectin genotypes and severe infections in patients with multiple myeloma receiving moderate strength induction chemotherapy. Methods: Chemotherapy‐related infections were identified retrospectively using clinical records and database files. Mannan‐binding lectin genotypes were identified with polymerase chain reaction on stored samples of stem cells or formalin‐fixed paraffin‐embedded bone marrow biopsies. Results: We included 138 myeloma patients. In five patients, data were incomplete, and 133 patients were analysed. Eighty‐eight patients were homozygous for wild‐type MBL2 (AA) and forty‐five patients were heterozygous or homozygous for variant genotypes (AO/OO). A total of 390 chemotherapy cycles were reviewed. Common Toxicity Criteria grades 3 and 4 infections in general were seen in relation to 104 cycles and were not more common in patient with variant MBL2 (P = 0.90). Septicaemia was seen after 10% of chemotherapy cycles in AA patients vs. 15% in AO/OO patients (P = 0.15). In multi‐variate analyses, we found indication of a reduced risk of septicaemia in AA patients [OR 0.27 (0.08–0.90), P = 0.03], after first chemotherapy cycle, but reduction of the risk including all cycles was not significant. A similar trend was seen for grades 3 and 4 infections in general. Conclusions: During induction chemotherapy in patients with multiple myeloma, a general protective effect of wild‐type MBL2 against chemotherapy‐related infections was not apparent in this study. However, we found indications of a reduced occurrence of septicaemia in patients with wild‐type compared with variant MBL2. Further studies in larger cohorts of patients are relevant.