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B.13.4% and 9.7%
According to a meta-analysis of data from phase II and phase III randomized, controlled clinical trials, the overall severe infection rate for patients with newly-diagnosed, autologous stem cell transplant (ASCT)-ineligible multiple myeloma was 13.4% following IMiD-based induction therapy and 9.7% following PI-based induction therapy, respectively.
D.All of the above
Severe active infections involving pneumonia, herpes zoster, HBV, HCV, CMV disease, tuberculosis, or HIV disease are contraindications for active antimyeloma therapy until they are completely resolved or controlled.
The infection-related death rate for patients undergoing IMiD-based antimyeloma therapy is 4.4%.
Among patients undergoing IMiD-based maintenance therapy following ASCT, the severe infection rate is 10.5%. This is not greater than prednisolone or placebo, but lenalidomide maintenance therapy involves twice the risk of severe infection compared to thalidomide.
Among patients with relapsed/refractory multiple myeloma, severe infection rates are 23.3% following bortezomib treatment and 16.6% following IMiD therapy. However, these increased infection rates might reflect, at least in part, differences in underlying disease severity.