A nationwide study on inpatient opportunistic infections in patients with chronic lymphocytic leukemia in the pre-ibrutinib era
(2021) In European Journal of Haematology 106(3). p.346-353- Abstract
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... (More)
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.
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- author
- Steingrímsson, Vilhjálmur ; Gíslason, Gauti Kjartan ; Þorsteinsdóttir, Sigrún ; Rögnvaldsson, Sæmundur ; Gottfreðsson, Magnús ; Aspelund, Thor ; Turesson, Ingemar LU ; Björkholm, Magnus ; Landgren, Ola and Kristinsson, Sigurdur Y.
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- chronic lymphocytic leukemia, immunology and infectious diseases, lymphoproliferative diseases
- in
- European Journal of Haematology
- volume
- 106
- issue
- 3
- pages
- 346 - 353
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85097026813
- pmid:33211356
- ISSN
- 0902-4441
- DOI
- 10.1111/ejh.13553
- language
- English
- LU publication?
- no
- id
- cc488973-98c1-4f6f-88f1-4670933640f0
- date added to LUP
- 2020-12-14 12:02:00
- date last changed
- 2024-05-30 01:18:58
@article{cc488973-98c1-4f6f-88f1-4670933640f0,
abstract = {{<p>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.</p>}},
author = {{Steingrímsson, Vilhjálmur and Gíslason, Gauti Kjartan and Þorsteinsdóttir, Sigrún and Rögnvaldsson, Sæmundur and Gottfreðsson, Magnús and Aspelund, Thor and Turesson, Ingemar and Björkholm, Magnus and Landgren, Ola and Kristinsson, Sigurdur Y.}},
issn = {{0902-4441}},
keywords = {{chronic lymphocytic leukemia; immunology and infectious diseases; lymphoproliferative diseases}},
language = {{eng}},
number = {{3}},
pages = {{346--353}},
publisher = {{Wiley-Blackwell}},
series = {{European Journal of Haematology}},
title = {{A nationwide study on inpatient opportunistic infections in patients with chronic lymphocytic leukemia in the pre-ibrutinib era}},
url = {{http://dx.doi.org/10.1111/ejh.13553}},
doi = {{10.1111/ejh.13553}},
volume = {{106}},
year = {{2021}},
}