Outcomes and Risk Factors of RSV and Influenza in Lymphoma and Multiple Myeloma Patients

Overview

This 7-year retrospective study analyzed 490 respiratory viral infection episodes in 440 patients with lymphoma or multiple myeloma, identifying key risk factors for lower respiratory tract infections (LRI) and mortality. RSV infection, smoking history, steroid use, lymphopenia, and elevated creatinine were associated with LRI, while multiple myeloma diagnosis, smoking, lymphopenia, and nosocomial infection predicted 30-day mortality.

Background

Respiratory viral infections (RVIs) such as influenza virus (IFV) and respiratory syncytial virus (RSV) cause significant morbidity and mortality in patients with hematologic malignancies. While risk factors for LRI and mortality have been studied in hematopoietic cell transplant recipients, data remain limited for lymphoma and multiple myeloma (MM) patients. Previous small studies reported high rates of LRI progression, hospitalization, ICU admission, and mortality in these populations. Identifying prognostic factors could improve early intervention and outcomes.

Data Highlights

Key Findings

• RSV infection was independently associated with increased risk of LRI compared to influenza virus.
• Current or former smoking, steroid exposure, lymphopenia (≤200 cells/mL), and elevated serum creatinine were significant risk factors for LRI development.
• Multiple myeloma diagnosis, smoking history, lymphopenia, and nosocomial infection were linked to higher 30-day all-cause mortality.
• LRI diagnosis, smoking, and lymphopenia were associated with increased 90-day mortality.
• Over half of patients required hospitalization, and a notable proportion required ICU care, underscoring the severity of RSV and IFV infections in these populations.

Clinical Implications

Clinicians should recognize RSV infection, smoking history, steroid use, lymphopenia, and renal impairment as important risk factors for LRI and mortality in lymphoma and multiple myeloma patients with respiratory viral infections. Early identification of high-risk patients may facilitate prompt management and potentially improve outcomes. Vigilance for nosocomial infections is also critical given their association with mortality.

Conclusion

This study highlights the substantial burden of RSV and influenza infections in lymphoma and multiple myeloma patients and identifies key risk factors for LRI and mortality. These findings can guide risk stratification and inform timely therapeutic interventions to reduce adverse outcomes.

References

1. Assessment of Outcomes and Contributing Factors for Lower Respiratory Tract Infections and Mortality Associated with Influenza and Respiratory Syncytial Virus in Patients Diagnosed with Lymphoma or Multiple Myeloma: A 7-Year Retrospective Analysis