Table 2.
Infection rates in regimens associated with high levels of neutropenia in selected regimens of interest
| Author/date | Regimen | Grade 3 and 4 neutropenia, % | Grade 3 and 4 infection, % | Febrile neutropenia, % |
|---|---|---|---|---|
| Bortezomib–dexamethasone-based | ||||
| Jimenez-Zepeda et al. [15] | RVD | 7 | 26 | NR |
| Durie et al. [14] | RVD | 19 | NR | NR |
| Garcia-Sanchez et al. [16] | VTD | 9 | NR | NR |
| Takashima et al. [19] | VTD | 17 | 21 (not specified if grade 3–4) | NR |
| Wu et al. [20] | VTD | 43.3 (VTD) 40 (improved VTD) |
NR | NR |
| Moreau et al. [17] | VTD | 12 | NR | NR |
| Niesvizky et al. [18] | VTD | 3 | NR | NR |
| Palumbo et al. [22] | PAD | 36 | 15 (serious infection) | 3 |
| Mai et al. [21] | PAD | 11 | 13 (serious infection) | NR |
| Moreau et al. [17] | VCD | 23 | NR | NR |
| Mai et al. [21] | VCD | 35 | 11 (serious infection) | NR |
| Kusano et al. [23] | VCD | 50 | NR | NR |
| Melphalan–prednisone-based | ||||
| Hulin et al. [47] | MP | 9 | NR | NR |
| Richardson et al. [48] | MP | 38 | NR | 4 |
| Palumbo et al. [49] | MP | 37 | 7 | 0 |
| Palumbo et al. [50] | MPR | 52 | 0.8 | NR |
| Palumbo et al. [49] | MPR plus lenalidomide maintenance | 67 grade 3 and 35 grade 4 | 11 | 7 |
| MPR | 64 grade 3 and 32 grade 4 | 15 | 2 | |
| Hulin et al. [47] | MPT | 23 | Neutropenia did not translate into more frequent severe infections | |
| Facon et al. [28] | MPT | 45 | 17 | 3 |
| Niesvizky et al. [18] | VMP | 21 | NR | NR |
| Richardson et al. [48] | VMP | 40 | NR | 3 |
| Palumbo et al. [51] | VMP | 28 | 9 | 2 |
| Lenalidomide–dexamethasone-based | ||||
| Dimopoulos et al. [27] | RD (low dose) | 3 | NR | NR |
| Dimopoulos et al. [27] | RD (intermediate dose) | 23 | NR | NR |
| Mookerjee et al. [35] | RD | 11 | NR | NR |
| Firatli Tuglular et al. [30] | RD | 10 | NR | NR |
| Durie [14] | RD | 21 | NR | NR |
| Zonder et al. [39] | RD | 21 | 16 | NR |
| Beksac et al. [25] | RD | 16 | NR | 4 |
| Tosi et al. [38] | RD | 35 | 15 | NR |
| Fouquet et al. [32] | RD | 16 | NR | NR |
| Family et al. [29] | RD (4 cycles) | 24 | 3.8 | |
| Huang et al. [34] | RD | 20 | 9 | NR |
| Dimopoulos et al. [26] | RD | 17 | 0 | |
| Firatli Tuglular et al. [31] | RD | 24 | 11 | NR |
| Gay et al. [52] | RD | 24 | 6 | NR |
| Moreau et al. [36] | RD | 16 | NR | NR |
| Weber et al. [46] | RD | 41 | 22 | 3 |
| Dimopoulos et al. [41] | RD | 30 | 11 | 3 |
| Geraldes et al. [33] | RD | 35 | 25 | NR |
| Schwarzer et al. [37] | RD | 32 | 11 | <1 |
| Facon et al. [28] | RD | 28 | 29 | 1 |
| Leleu et al. [42] | RD | 31 | NR | 3 |
| Stewart et al. [44] | RD | 27 | NR | NR |
| Lonial et al. [43] | RD | 44 | NR | NR |
| Sun et al. [45] | RD | 61 | 37 | NR |
| Alegre et al. [40] | RD | 51 | NR | 6 |
| Durie et al. [14] | RVD RD |
19 21 |
NR | NR |
| Jimenez-Zepeda et al. [15] | RVD | 7 | 26 | NR |
| Pomalidomide-based | ||||
| Dimopoulos et al. [53] | PD | 50 | NR | NR |
| Maciocia et al. [54] | PD | 35 | Neutropenic sepsis, 11 | NR |
| Miles and Wells [55] | PD | 26 | Sepsis requiring admission, 24 | NR |
| San Miguel et al. [56] | PD | 48 | 30 | 10 |
| High-dose melphalan | ||||
| Cook et al. [57] | HD-M plus salvage ASCT | 75 | NR | NR |
| Palumbo et al. [58] | HD-M | 77 | 40 | 17 |
| Palumbo et al. [50] | HD-M | 94 | 16.3 (includes febrile neutropenia) | NR |
| Gay et al. [59] | HD-M | 80 | 19 | NR |
ASCT autologous stem cell transplantation, HD-M high-dose melphalan, MP melphalan/prednisone, MPR melphalan/prednisone/lenalidomide, MPT melphalan/prednisone/thalidomide, NR not reported, PD pomalidomide/dexamethasone, RD lenalidomide/dexamethasone, RVD lenalidomide/bortezomib/dexamethasone, VMP bortezomib/melphalan/prednisone