Ken Shain, MD
KEN SHAIN, MD, Assistant Member of the Department of Malignant Hematology and Tumor Biology, Moffitt Cancer Center in Tampa, Florida, and Scientific Director of the Moffitt Myeloma Working Group, moderated the session where the study was presented and offered comments to The ASCO Post. “Professor Drayson and his team asked the question of whether prophylactic antibiotics improve outcomes (decrease early death) in newly diagnosed patients with multiple myeloma. This represents an underappreciated aspect of myeloma patient care,” he said.
The TEAMM study examined the use of prophylactic levofloxacin vs placebo in nearly 1,000 newly diagnosed patients with multiple myeloma in Great Britain. Using the primary endpoint of time to febrile episode and/or death, the study showed a statistically significant improvement in outcomes with a 34% reduction in risk (hazard ratio = 0.66). Importantly, there was no evidence of increased risk of the carriage of resistant bacteria, he emphasized.
“This is a very exciting study, suggesting that by providing additional supportive care to our patients we can decrease morbidity and mortality,” Dr. Shain said. “At this time, the wholesale adoption of this practice will involve collaborative efforts between myeloma doctors and local/regional infectious disease specialists to determine the appropriate risk/benefit of this practice. However, in my opinion, this should begin to change our collective thoughts on prophylactic antibiotic use in the newly diagnosed setting.” ■
DISCLOSURE: Dr. Shain reported no conflicts of interest.
IN PATIENTS undergoing treatment of multiple myeloma, the prophylactic use of levofloxacin significantly reduced febrile episodes and deaths, without increasing healthcare-associated infections or carriage of key nosocomial pathogens, in a large multicenter study from the United Kingdom.1 The...