Supportive Care in Cancer

, Volume 26, Issue 7, pp 2425–2431 | Cite as

Community-acquired respiratory infections are common in patients with non-Hodgkin lymphoma and multiple myeloma

  • Noa Lavi
  • Irit Avivi
  • Zipora Kra-Oz
  • Ilana Oren
  • Emilia Hardak
Original Article



Available data suggest that respiratory infections are associated with increased morbidity and mortality in patients hospitalized due to acute leukemia and allogeneic stem cell transplantation (allo-SCT). However, the precise incidence, risk factors, and severity of respiratory infection, mainly community-acquired, in patients with lymphoma and multiple myeloma (MM) are not fully determined. The current study aimed to investigate risk factors for respiratory infections and their clinical significance in patients with B cell non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) in the first year of diagnosis.


Data of consecutive patients diagnosed with NHL or MM and treated at the Rambam Hematology Inpatient and Outpatient Units between 01/2011 and 03/2012 were evaluated. Information regarding anticancer treatment, incidence and course of respiratory infections, and infection-related outcomes was analyzed.


One hundred and sixty episodes of respiratory infections were recorded in 103 (49%) of 211 (73-MM, 138-NHL) patients; 126 (79%) episodes were community-acquired, 47 (29%) of them required hospitalization. In univariate analysis, age < 60 years, MM diagnosis, and autologous SCT increased the respiratory infection risk (P = 0.058, 0.038, and 0.001, respectively). Ninety episodes (56% of all respiratory episodes) were examined for viral pathogens. Viral infections were documented in 25/90 (28%) episodes, 21 (84%) of them were community-acquired, requiring hospitalization in 5 (24%) cases. Anti-flu vaccination was performed in 119 (56%) patients. Two of the six patients diagnosed with influenza were vaccinated.


Respiratory infections, including viral ones, are common in NHL and MM. Most infections are community-acquired and have a favorable outcome. Rapid identification of viral pathogens allows avoiding antibiotic overuse in this patient population.


Multiple myeloma Non-Hodgkin lymphoma (NHL) Respiratory infection Viral infection 



The authors would like to thank Sonia Kamenetsky for the preparation of this manuscript.

Compliance with ethical standards

The current retrospective study was approved by the Institutional Review Board of the Rambam Health Care Campus in Haifa, Israel (approval no. 0229-13).

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Noa Lavi
    • 1
  • Irit Avivi
    • 2
    • 3
  • Zipora Kra-Oz
    • 4
    • 5
  • Ilana Oren
    • 5
    • 6
  • Emilia Hardak
    • 5
    • 7
  1. 1.Department of Hematology and Bone Marrow TransplantationRambam Health Care CampusHaifaIsrael
  2. 2.Department of Hematology and Bone Marrow TransplantationTel Aviv Sourasky Medical CenterTel AvivIsrael
  3. 3.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  4. 4.Virology LaboratoryRambam Health Care CampusHaifaIsrael
  5. 5.Bruce Rappaport Faculty of MedicineTechnion, Israel Institute of TechnologyHaifaIsrael
  6. 6.Infectious Diseases UnitRambam Health Care CampusHaifaIsrael
  7. 7.Division of Pulmonary MedicineRambam Health Care CampusHaifaIsrael

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