S Molica1, D Levato, L Levato. 1. Divisione di Ematologia, Ospedale Regionale A. Pugliese Catanzaro, Italy.
Abstract
BACKGROUND AND METHODS: Infections represent the major cause of death in chronic lymphocytic leukemia (CLL); however, clinical studies dealing with their incidence have yielded inconclusive results. In order to address this issue we reviewed the records of 125 CLL patients (mean age 65.6 yrs; 81 M/44 F; Stage A, 48; Stage B, 37; Stage C, 40) followed up at our institution over a 10-year period. RESULTS: The 125 patients accrued 447 person-years, a mean of 3.8 years per person. There were 199 recorded infections: 47 severe (crude rate 9.8 per 100 person-years) and 72 moderate, respectively. The 5-year risk of developing a severe infection for the whole series was 26% (95% CI: 24.7-27.3%), and 21 out of 71 deaths (29.5%) could be attributed to infectious causes. Despite a linear trend toward increased risk (r = 0.98), hazard function analysis showed a constant pattern of risk (r = 0.30), suggesting a lack of correlation of this event with time. Furthermore, the 5-year risk of developing a severe infection increased to 57.1% (95% CI: 36.4-77.8%) for patients with low IgG levels (less than 6.5 gr/L), and to 68% for those with both low IgG levels and disease stage C. On the other hand, patients who experienced a severe infection more frequently had advanced clinical stage (P < 0.001), low IgG levels (P < 0.01) and diffuse bone marrow (BM) histology (P < 0.05). CONCLUSIONS: Infection is a constant risk in CLL that is associated with shortened survival. Factors such as hypogammaglobulinemia and advanced disease appear to be the major predisposing factors.
BACKGROUND AND METHODS: Infections represent the major cause of death in chronic lymphocytic leukemia (CLL); however, clinical studies dealing with their incidence have yielded inconclusive results. In order to address this issue we reviewed the records of 125 CLL patients (mean age 65.6 yrs; 81 M/44 F; Stage A, 48; Stage B, 37; Stage C, 40) followed up at our institution over a 10-year period. RESULTS: The 125 patients accrued 447 person-years, a mean of 3.8 years per person. There were 199 recorded infections: 47 severe (crude rate 9.8 per 100 person-years) and 72 moderate, respectively. The 5-year risk of developing a severe infection for the whole series was 26% (95% CI: 24.7-27.3%), and 21 out of 71 deaths (29.5%) could be attributed to infectious causes. Despite a linear trend toward increased risk (r = 0.98), hazard function analysis showed a constant pattern of risk (r = 0.30), suggesting a lack of correlation of this event with time. Furthermore, the 5-year risk of developing a severe infection increased to 57.1% (95% CI: 36.4-77.8%) for patients with low IgG levels (less than 6.5 gr/L), and to 68% for those with both low IgG levels and disease stage C. On the other hand, patients who experienced a severe infection more frequently had advanced clinical stage (P < 0.001), low IgG levels (P < 0.01) and diffuse bone marrow (BM) histology (P < 0.05). CONCLUSIONS:Infection is a constant risk in CLL that is associated with shortened survival. Factors such as hypogammaglobulinemia and advanced disease appear to be the major predisposing factors.
Authors: Steven E Coutre; John C Byrd; Peter Hillmen; Jacqueline C Barrientos; Paul M Barr; Stephen Devereux; Tadeusz Robak; Thomas J Kipps; Anna Schuh; Carol Moreno; Richard R Furman; Jan A Burger; Michael O'Dwyer; Paolo Ghia; Rudolph Valentino; Stephen Chang; James P Dean; Danelle F James; Susan M O'Brien Journal: Blood Adv Date: 2019-06-25
Authors: Aliénor Xhaard; Loic Epelboin; David Schnell; François Vincent; Vincent Levy; Marion Malphettes; Elie Azoulay; Michaël Darmon Journal: Support Care Cancer Date: 2013-02-15 Impact factor: 3.603
Authors: Meredith S Shiels; Ola Landgren; Rene Costello; Adriana Zingone; James J Goedert; Eric A Engels Journal: Clin Infect Dis Date: 2012-08-14 Impact factor: 9.079
Authors: S Lachance; A L Christofides; J K Lee; L H Sehn; B C Ritchie; C Shustik; D A Stewart; C L Toze; E Haddad; D C Vinh Journal: Curr Oncol Date: 2016-02-18 Impact factor: 3.677
Authors: C Steininger; L Z Rassenti; K Vanura; K Eigenberger; U Jäger; T J Kipps; C Mannhalter; S Stilgenbauer; T Popow-Kraupp Journal: Eur J Clin Invest Date: 2009-06 Impact factor: 4.686
Authors: Katrina Vanura; Franz Rieder; Marie-Theres Kastner; Julia Biebl; Michael Sandhofer; Trang Le; Robert Strassl; Elisabeth Puchhammer-Stöckl; Thomas Perkmann; Christoph F Steininger; Kostas Stamatopoulos; Wolfgang Graninger; Ulrich Jäger; Christoph Steininger Journal: PLoS One Date: 2013-10-23 Impact factor: 3.240