One-in-four adult patients hospitalized with invasive pneumococcal disease showed M protein in their blood, leading to new diagnoses of blood cancer or precursor conditions.
RT’s Three Key Takeaways:
- Underlying Disease Detection: One-in-four adult patients hospitalized with invasive pneumococcal disease showed M protein in their blood, leading to new diagnoses of blood cancer or precursor conditions, according to study findings.
- Value of Routine Screening: Evaluating antibody levels and protein markers following severe lung infections could help clinicians identify undiagnosed immunodeficiencies and initiate preventive therapies early, researchers reported.
- Evolving Bacterial Strains: Shifts in circulating pneumococcal serotypes following childhood vaccination efforts highlight the need to update adult immunization recommendations to protect vulnerable populations.
Severe pneumococcal disease requiring hospitalization, most commonly pneumonia, can serve as an indicator of previously undiagnosed blood cancer and immunodeficiency in adult patients, according to a study from the University of Gothenburg published in Scientific Reports.
The investigation followed 156 individuals who developed invasive pneumococcal disease and required hospital care in Region Västra Götaland, Sweden, between 2018 and 2023. The median age of the patient cohort was 70 years. To assess immune function, investigators measured antibody levels and evaluated the presence of M protein, an established marker associated with blood cancer risk. Results were compared against a control group of 64 individuals matched for age and sex who did not have invasive pneumococcal disease.
Screening Identifies Malignancies and Immune Deficits
Within the pneumococcal infection cohort, one in four individuals had M protein detected in their blood. Following further diagnostic examinations, seven patients received a formal blood cancer diagnosis, and another 12 patients were diagnosed with precursor conditions that have the potential to progress to blood cancer.
Additionally, eight patients were found to have an underlying immunodeficiency, allowing seven of them to initiate preventive medical treatment against future severe infections. By comparison, these abnormalities were considerably less common in the matched control cohort.
Based on the data, the study authors suggested that healthcare teams consider implementing routine screening for M protein and antibody levels in adult patients hospitalized with invasive pneumococcal disease.
“Currently, these tests are not routinely performed after a severe pneumococcal infection. As a result, we may miss patients with undiagnosed blood cancer or immunodeficiency and therefore missing the opportunity to initiate treatment,” said Tor Härnqvist, a doctoral student at the University of Gothenburg, an infectious disease physician at NU Hospital Group, and one of the study’s lead authors, in a news release.
Implications for Adult Immunization Strategies
The research project, which forms part of a doctoral thesis by Karin Bergman at the University of Gothenburg, also examined shifting patterns in the bacterial strains responsible for serious respiratory disease.
Following the implementation of pneumococcal vaccines in the Swedish childhood vaccination program, bacterial serotypes targeted by the pediatric vaccine declined sharply, but they were largely replaced by replacement serotypes not covered by that vaccine. Older adults and patients with compromised immune systems, including those with cancer, are frequently affected by these circulating replacement strains.
“The results show that recommendations on pneumococcal vaccines for adults need to take into account which vaccines are used in children and which bacterial serotypes subsequently circulate in the community,” said Karin Bergman, a doctoral student at the University of Gothenburg and an infectious disease physician at Södra Älvsborg Hospital, in a news release.
