Visceral leishmaniasis in heavily pretreated multiple myeloma patients a case series of 17 patients from the Mediterranean Coast of Spain
Background and objectives The introduction of novel therapies in multiple myeloma (MM) has significantly improved survival rates. However, their immunosuppressive nature predisposes patients to serious opportunistic infections, including visceral leishmaniasis (VL). Due to the rarity of VL in MM pat...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2514075 |
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| author | Ana Monreal Bernal Mercedes Berenguer Piqueras Pedro Ortiz Salvador Marina Suarez Terron Ana Bataller Alfonso Soledad Delgado Palacio Maria Leonor Senent Peris Monica Roig Pellicer Ana Villalba Valenzuela Carmen Benet Campos Clara Espinosa Arnandis Elena Fernández Poveda Eduardo Salido Fierez Isabel Rodenas Quiñonero Felipe de Arriba de la Fuente Jaime Ortiz Andrade Javier Marco Ayala Maria L. Lozano Francisco J. Ortuño |
| author_facet | Ana Monreal Bernal Mercedes Berenguer Piqueras Pedro Ortiz Salvador Marina Suarez Terron Ana Bataller Alfonso Soledad Delgado Palacio Maria Leonor Senent Peris Monica Roig Pellicer Ana Villalba Valenzuela Carmen Benet Campos Clara Espinosa Arnandis Elena Fernández Poveda Eduardo Salido Fierez Isabel Rodenas Quiñonero Felipe de Arriba de la Fuente Jaime Ortiz Andrade Javier Marco Ayala Maria L. Lozano Francisco J. Ortuño |
| author_sort | Ana Monreal Bernal |
| collection | DOAJ |
| description | Background and objectives The introduction of novel therapies in multiple myeloma (MM) has significantly improved survival rates. However, their immunosuppressive nature predisposes patients to serious opportunistic infections, including visceral leishmaniasis (VL). Due to the rarity of VL in MM patients, specific management guidelines are lacking, and treatments are often extrapolated from those used for HIV-infected patients. This study aims to provide insights into the management of VL in MM patients.Patients We conducted a retrospective analysis of 17 patients diagnosed with MM and VL between 2014 and 2023 across hospitals on the Mediterranean coast of Spain. Clinical data, diagnostic methods, treatment responses, relapses, and outcomes were reviewed.Results Pancytopenia emerged as the most frequent presenting feature, accompanied by fever and splenomegaly in some cases. VL diagnosis was confirmed in all patients through visual analysis of bone marrow smears, while PCR and serological tests yielded inconsistent results. Treatment with the liposomal amphotericin B (lAmB) 40 regimen resulted in excellent initial responses; however, 53% of patients experienced relapses.Conclusions Given the high relapse rate, secondary prophylaxis should be considered for selected patients, particularly those with more than 5 years of MM diagnosis or who have received more than two lines of treatment or immunomodulatory drugs (IMiDs). This study highlights the need for tailored management strategies for VL in MM patients and underscores the importance of vigilant follow-up. |
| format | Article |
| id | doaj-art-657c84ecba8e49d79c0bbb1044d03cbc |
| institution | DOAJ |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-657c84ecba8e49d79c0bbb1044d03cbc2025-08-20T03:22:12ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2514075Visceral leishmaniasis in heavily pretreated multiple myeloma patients a case series of 17 patients from the Mediterranean Coast of SpainAna Monreal Bernal0Mercedes Berenguer Piqueras1Pedro Ortiz Salvador2Marina Suarez Terron3Ana Bataller Alfonso4Soledad Delgado Palacio5Maria Leonor Senent Peris6Monica Roig Pellicer7Ana Villalba Valenzuela8Carmen Benet Campos9Clara Espinosa Arnandis10Elena Fernández Poveda11Eduardo Salido Fierez12Isabel Rodenas Quiñonero13Felipe de Arriba de la Fuente14Jaime Ortiz Andrade15Javier Marco Ayala16Maria L. Lozano17Francisco J. Ortuño18Hospital General Universitario Morales Meseguer. IMIB-Arrixaca, Murcia, SpainHospital General Universitario Morales Meseguer. IMIB-Arrixaca, Murcia, SpainHospital Doctor Peset, Valencia, SpainHospital Universitario y Politécnico La Fe, Valencia, SpainHospital Universitario y Politécnico La Fe, Valencia, SpainHospital Universitario y Politécnico La Fe, Valencia, SpainHospital Universitario y Politécnico La Fe, Valencia, SpainHospital General Universitario, Valencia, SpainHospital de Sagunto. Sagunto, Valencia, SpainHospital Arnau de Vilanova, Valencia, SpainHospital General Universitario de Castellón, Castellón de la Plana, Castellón, SpainHospital Santa Lucia. Cartagena, Murcia, SpainHospital Universitario Virgen de la Arrixaca. IMIB-Arrixaca, Murcia, SpainHospital Rafael Mendez. Lorca, Murcia, SpainHospital General Universitario Morales Meseguer. IMIB-Arrixaca, Murcia, SpainHospital General Universitario Morales Meseguer. IMIB-Arrixaca, Murcia, SpainHospital General Universitario Morales Meseguer. IMIB-Arrixaca, Murcia, SpainHospital General Universitario Morales Meseguer. IMIB-Arrixaca, Murcia, SpainHospital General Universitario Morales Meseguer. IMIB-Arrixaca, Murcia, SpainBackground and objectives The introduction of novel therapies in multiple myeloma (MM) has significantly improved survival rates. However, their immunosuppressive nature predisposes patients to serious opportunistic infections, including visceral leishmaniasis (VL). Due to the rarity of VL in MM patients, specific management guidelines are lacking, and treatments are often extrapolated from those used for HIV-infected patients. This study aims to provide insights into the management of VL in MM patients.Patients We conducted a retrospective analysis of 17 patients diagnosed with MM and VL between 2014 and 2023 across hospitals on the Mediterranean coast of Spain. Clinical data, diagnostic methods, treatment responses, relapses, and outcomes were reviewed.Results Pancytopenia emerged as the most frequent presenting feature, accompanied by fever and splenomegaly in some cases. VL diagnosis was confirmed in all patients through visual analysis of bone marrow smears, while PCR and serological tests yielded inconsistent results. Treatment with the liposomal amphotericin B (lAmB) 40 regimen resulted in excellent initial responses; however, 53% of patients experienced relapses.Conclusions Given the high relapse rate, secondary prophylaxis should be considered for selected patients, particularly those with more than 5 years of MM diagnosis or who have received more than two lines of treatment or immunomodulatory drugs (IMiDs). This study highlights the need for tailored management strategies for VL in MM patients and underscores the importance of vigilant follow-up.https://www.tandfonline.com/doi/10.1080/07853890.2025.2514075Bone marrow smearliposomal amphotericin Bmultiple myelomavisceral leishmaniasis |
| spellingShingle | Ana Monreal Bernal Mercedes Berenguer Piqueras Pedro Ortiz Salvador Marina Suarez Terron Ana Bataller Alfonso Soledad Delgado Palacio Maria Leonor Senent Peris Monica Roig Pellicer Ana Villalba Valenzuela Carmen Benet Campos Clara Espinosa Arnandis Elena Fernández Poveda Eduardo Salido Fierez Isabel Rodenas Quiñonero Felipe de Arriba de la Fuente Jaime Ortiz Andrade Javier Marco Ayala Maria L. Lozano Francisco J. Ortuño Visceral leishmaniasis in heavily pretreated multiple myeloma patients a case series of 17 patients from the Mediterranean Coast of Spain Annals of Medicine Bone marrow smear liposomal amphotericin B multiple myeloma visceral leishmaniasis |
| title | Visceral leishmaniasis in heavily pretreated multiple myeloma patients a case series of 17 patients from the Mediterranean Coast of Spain |
| title_full | Visceral leishmaniasis in heavily pretreated multiple myeloma patients a case series of 17 patients from the Mediterranean Coast of Spain |
| title_fullStr | Visceral leishmaniasis in heavily pretreated multiple myeloma patients a case series of 17 patients from the Mediterranean Coast of Spain |
| title_full_unstemmed | Visceral leishmaniasis in heavily pretreated multiple myeloma patients a case series of 17 patients from the Mediterranean Coast of Spain |
| title_short | Visceral leishmaniasis in heavily pretreated multiple myeloma patients a case series of 17 patients from the Mediterranean Coast of Spain |
| title_sort | visceral leishmaniasis in heavily pretreated multiple myeloma patients a case series of 17 patients from the mediterranean coast of spain |
| topic | Bone marrow smear liposomal amphotericin B multiple myeloma visceral leishmaniasis |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2514075 |
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