Risk and impact of tuberculosis in patients with multiple myeloma*

Abstract

We investigated the risk and impact of mycobacterium tuberculosis (TB) infection in patients with multiple myeloma (MM). We identified 3979 MM patients from Taiwan’s National Health Insurance database between 2000 and 2011 and compared the incidence rates of TB infection in these patients with 15,916 randomly selected age-, sex-, and comorbidity-matched subjects without MM. The risk of TB was higher in the myeloma cohort (adjusted hazard ratio [HR] 3.11, 95% confidence interval [CI] 2.41–4.02). Risk factors for MM patients contracting TB were age ≥65 (adjusted HR 1.93, 95% CI 1.19–3.15), alcohol use disorder (adjusted HR 2.86, 95% CI 1.24–6.62), and steroid daily dose equivalent to prednisone 5 mg or more (adjusted HR 2.38, 95% CI 1.50–3.77). MM patients with TB had a higher mortality risk than those without (adjusted HR 2.03, 95% CI 1.54–2.67). The incidence of TB is significantly higher in MM patients.

Keywords:

• Myeloma
• Infectious complications
• T-Cell Mediated Immunity
• Innate Immunity

Acknowledgements

This study is based on data from the National Health Insurance Research Database, provided by the Bureau of National Health Insurance, Department of Health, and managed by the National Health Research Institutes. The interpretation and conclusions contained herein do not represent those of the Bureau of National Health Insurance, Department of Health, or the National Health Research Institutes.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at http://dx.doi.org/10.1080/10428194.2017.1312369.

Additional information

Funding

This study was supported by grants from Taipei Veterans General Hospital [V105B-016 and V105E10-002-MY2-1], the Ministry of Science and Technology [MOST 104-2314-B-075-085-MY2], the Taiwan Clinical Oncology Research Foundation, Szu-Yuan Research Foundation of Internal Medicine, and Chong Hin Loon Memorial Cancer and Biotherapy Research Center at National Yang-Ming University.