02967nas a2200409   4500000000100000008004100001260002300042653002100065653003200086653002200118653002900140100002100169700002500190700002100215700002000236700002300256700002200279700002000301700002000321700002600341700001900367700002300386700002400409700002000433700002500453700002900478700002000507700001800527700001400545700001500559245014200574856007000716300000700786490000700793520173200800022002502532       2025                            d  bInforma UK Limited10aMultiple Myeloma10aVisceral leishmaniasis (VL)10aBone marrow smear10aLiposomal amphotericin B1 aMonreal Bernal A1 aBerenguer Piqueras M1 aOrtiz Salvador P1 aSuarez Terron M1 aBataller Alfonso A1 aDelgado Palacio S1 aSenent Peris ML1 aRoig Pellicer M1 aVillalba Valenzuela A1 aBenet Campos C1 aEspinosa Arnandi C1 aFernández Poveda E1 aSalido Fierez E1 aRodenas Quiñonero I1 ade Arriba de la Fuente F1 aOrtiz Andrade J1 aMarco Ayala J1 aLozano ML1 aOrtuño FJ00aVisceral leishmaniasis in heavily pretreated multiple myeloma patients a case series of 17 patients from the Mediterranean Coast of Spain  uhttps://www.tandfonline.com/doi/pdf/10.1080/07853890.2025.2514075  a100 v573 a<p><strong>Background and objectives:</strong>&nbsp; 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.</p>

<p><strong>Patients:&nbsp;</strong> 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.</p>

<p><strong>Results:&nbsp;</strong> 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.</p>

<p><strong>Conclusions:</strong>&nbsp;Given the high relapse rate, secondary prophylaxis should be considered for selected patients, particularly those with more than 5&nbsp; 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.</p>
  a0785-3890, 1365-2060