ABSTRACT
Recurrent infections are a common clinical problem in patients with 8-cell lymphoproliferative diseases such as chronic lymphocytic leukemia (CLL) and multiple myeloma. Many of these patients are elderly, and infectious diseases are a major cause of morbidity and mortality in such a population; however, there is a higher rate of infection in such patients when compared with age-matched controls. Twomey followed 45 patients with CLL, 50 patients with multiple myeloma, and a control group of 50 patients of a similar age range who had survived myocardial infarction. The annual infection rate was five times higher in patients with CLL and 15 times higher in patients with multiple myeloma compared with the age-matched control group (Fig. 1). Infections contributed to the higher mortality in patients with CLL and multiple myeloma (1). The increased infection rate seen in patients with multiple myeloma is not reflected in other plasma cell disorders, such as Waldenstrom's macroglobulinemia or monoclonal gammopathy of uncertain significance (2) (Table 1). Prevention of infection in patients with CLL and multiple myeloma should considerably reduce morbidity and mortality in this group of patients, with subsequent improvement in quality of life (3).
