A population-based study on serious inpatient bacterial infections in patients with chronic lymphocytic leukemia and their impact on survival

被引:3
作者
Steingrimsson, Vilhjalmur [1 ]
Gislason, Gauti K. [1 ]
Aspelund, Thor [2 ]
Turesson, Ingemar [3 ]
Bjorkholm, Magnus [4 ,5 ]
Landgren, Ola [6 ]
Kristinsson, Sigurdur Y. [1 ,4 ,5 ]
机构
[1] Univ Iceland, Fac Med, Sturlugata 8, IS-101 Reykjavik, Iceland
[2] Univ Iceland, Ctr Publ Hlth Sci, Reykjavik, Iceland
[3] Skane Univ Hosp, Dept Hematol & Coagulat Disorders, Malmo, Sweden
[4] Karolinska Univ Hosp, Dept Med, Stockholm, Sweden
[5] Karolinska Inst, Stockholm, Sweden
[6] Mem Sloan Kettering Canc Ctr, Myeloma Serv, 1275 York Ave, New York, NY 10021 USA
基金
美国国家卫生研究院;
关键词
chronic lymphocytic leukemia; immunology and infectious diseases; lymphoproliferative diseases; BLOOD-STREAM INFECTIONS; MAJOR INFECTIONS; COMPLICATIONS; PATHOGENESIS; CHLORAMBUCIL; PROPHYLAXIS; FLUDARABINE; SPECTRUM; COHORT; RISK;
D O I
10.1111/ejh.13477
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective Infections in chronic lymphocytic leukemia (CLL) have been thoroughly investigated in the setting of clinical trials and single-center studies. However, large cohort studies on real-world data and studies on temporal trends are lacking. We performed a nationwide study on serious bacterial infections in CLL. Methods Using high-quality Swedish government-based registries, 13 009 CLL patients diagnosed in 1982-2013 and their 49 380 matched controls were included. Results Overall, CLL patients had an increased risk of serious inpatient bacterial infections with a hazard ratio (HR) 5.32 and 95% confidence interval (95% CI) 5.11-5.53, and the highest risk was observed for septicemia (HR 6.91, 95% CI 6.46-7.39) and lung infections (5.91, 5.64-6.18). The risk of serious inpatient bacterial infections decreased overtime with HR 0.87 (0.81-0.94) and HR 0.76 (0.70-0.82) in 1993-2002 and 2003-2013, respectively, compared to 1982-1992. CLL patients had an increased risk of death following a serious inpatient bacterial infection compared to matched CLL patients, and the risk was highest in the first 12 months after the infection (HR 5.48, 95% CI 5.11-5.90). Conclusion We have, in this nationwide study, characterized the risk of serious bacterial infections in CLL patients and, importantly, depicted that the risk has decreased overtime.
引用
收藏
页码:547 / 554
页数:8
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