Levels of N-Terminal Pro-B-Type Natriuretic Peptide Relate to Risk of Infection in Multiple Myeloma Patients

Background

Infections are a major complication in multiple myeloma (MM) patients and are associated with inferior outcomes. Thus there is a pressing need to predict risk of infection in MM patients.

Methods

Data from 110 MM patients were retrospectively analyzed. Patients were divided into high and low N-amino terminal fragment of the N-terminal pro-B-type natriuretic peptide (NT-proBNP) groups using the cut-off value 300ng/L at diagnosis.

Results

This study showed patients with high NT-proBNP had significantly higher beta-2-micorglobin (B2M), creatinine, lactate dehydrogenase (LDH), Eastern Cooperative Oncology Group performance status (ECOG-PS) score, international staging system (ISS) score and lower estimated glomerular filtration rate (eGFR), hemoglobin, albumin than patients with low NT-proBNP. During the follow-up period, 46% presented at least one grade ≥3 infection. Patients with high NT-proBNP had high cumulative incidences of infections at the first 4 months and at the end of follow-up. Multivariate Cox regression analysis proved NT-proBNP to be an independent significant prognostic factor for grade ≥3 infections (relative ratio [RR] 2.190, 95% confidence interval [CI]: 1.126-4.261, P = 0.021).

Conclusions

This study revealed the potential of NT-proBNP for predicting risk of infection in MM patients. NT-proBNP may be applied as a criterion to identify patients with high risk of infection, who can benefit from prophylactic measures.