A nationwide study on inpatient opportunistic infections in patients with chronic lymphocytic leukemia in the pre-ibrutinib era.

• Published in: European Journal of Haematology
• Main Authors: Steingrímsson, Vilhjálmur, Gíslason, Gauti Kjartan, Þorsteinsdóttir, Sigrún, Rögnvaldsson, Saemundur, Gottfreðsson, Magnús, Aspelund, Thor, Turesson, Ingemar, Björkholm, Magnus, Landgren, Ola, Kristinsson, Sigurdur Y
• Other Authors: 1Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2Department of Infectious Diseases, Landspitali University Hospital, Reykjavik, Iceland. 3Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland. 4Department of Hematology and Coagulation Disorders, Skane University Hospital, Malmö, Sweden. 5Department of Medicine, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. 6Myeloma Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2021
• Subjects: chronic lymphocytic leukemia; immunology and infectious diseases; lymphoproliferative diseases; Hvítblæði; Sýkingar; Opportunistic Infections; Leukemia; Lymphocytic; Chronic; B-Cell; Iceland
• Online Access: http://hdl.handle.net/2336/621629; https://doi.org/10.1111/ejh.13553

To access publisher's full text version of this article click on the hyperlink below Objective: Opportunistic infections in chronic lymphocytic leukemia (CLL) have been described in clinical trials, single-center studies, and case reports. We performed a nationwide study to estimate the incidence and impact of inpatient opportunistic infections. Methods: The incidence rate (IR) and incidence rate ratio (IRR) for Swedish CLL patients diagnosed 1994-2013, and matched controls were calculated, as well as the case-fatality ratio (CFR). Results: Among 8989 CLL patients, a total of 829 opportunistic infections were registered (IR 16.6 per 1000 person-years) compared with 252 opportunistic infections in 34 283 matched controls (IR 0.99). The highest incidence in the CLL cohort was for Pneumocystis pneumonia (200 infections, IR 4.03); Herpes zoster (146 infections, IR 2.94), and Pseudomonas (83 infections, IR 1.66) infections. The highest risk relative to matched controls was observed for Pneumocystis pneumonia (IRR 114, 95% confidence interval 58.7-252). The 60-day CFR for CLL patients with opportunistic infections was 23% (188/821), highest for progressive multifocal encephalopathy (5/7, 71%) and aspergillosis (25/60, 42%). Conclusion: We have uniquely depicted the incidence of rare and serious infections in CLL patients and found a relatively high incidence of Pneumocystis pneumonia. Of the most common opportunistic infections, CLL patients with aspergillosis had the poorest prognosis. Keywords: chronic lymphocytic leukemia; immunology and infectious diseases; lymphoproliferative diseases. Swedish Cancer Society Pfizer United States Department of Health & Human Services National Institutes of Health (NIH) - USA Celgene Landspitali University Hospital Research Fund Rising Tides Foundation Amgen International Myeloma Foundation (IMF) Perelman Family Foundation Swedish Blodcancerfunden Karolinska Institutet University of Iceland Research Fund, Icelandic Centre for Research (RANNIS) Seattle Genetics Stockholm ...