scholarly journals Prophylactic antibiotic treatment with TMP-SMX decreased the incidence of interstitial pneumonia in patients with B-cell lymphoma on chemotherapy

2020 ◽  
Author(s):  
Cong Li ◽  
Fangxiao Lu ◽  
Lei Tao ◽  
Haifeng Yu ◽  
Xi Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
B Cell ◽  
Interstitial Pneumonia ◽  
Prophylactic Treatment ◽  
Significant Risk ◽  
Prophylactic Antibiotic ◽  
B Cell Lymphoma ◽  
Once Daily ◽  
Non Hodgkin Lymphoma ◽  
Associated Risk Factors

Abstract Background Several studies have reported the incidence of interstitial pneumonia (IP) among patients with non-Hodgkin lymphoma (NHL) that are undergoing combination chemotherapy plus rituximab; however, the effective prophylactic treatment for IP remains unclear. This study aims to explore the prophylactic effect of trimethoprim-sulfamethoxazole (TMP-SMX) on IP and identify IP-associated risk factors in NHL patients.Methods Between March 2013 and April 2018, 498 patients (264 males, 53%) with B-cell NHL undergoing first-line RCHOP-like chemotherapy treatment with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone were enrolled in this study.Results These patients had a median age of 56 years, and 311 of the 498 patients (62.4%) were administered once daily with the prophylactic treatment of TMP-SMX. IP occurred in 65 patients (13.1%), indicating a significant reduction in the IP incidence rate (21.4% vs. 8.0%; p<0.001). Among patients treated with TMP-SMX, 2 (1.2%) exhibited rashes, 38 (12.2%) suffered from nausea and vomiting, 52 (16.7%) showed signs of neutropenia, and 18 (5.8%) suffered from kidney dysfunction. Both univariate and multivariate analysis showed that gender (male), history of diabetes, and absence of prophylactic TMP-SMX treatment were significant risk factors associated with IP. Disease progression was observed in 55/311 (17.7%) patients that underwent prophylactic TMP-SMX treatment and in 63/187 (33.7%) patients that did not (p<0.001).Conclusions This study revealed that the occurrence of IP was common in B-cell NHL patients undergoing combined chemotherapy plus rituximab treatment. IP could be reduced with prophylactic treatment of once-daily oral TMP-SMX.

scholarly journals Prophylactic antibiotic treatment with TMP-SMX decreased the incidence of interstitial pneumonia in patients with B-cell lymphoma on chemotherapy

2020 ◽  
Author(s):  
Cong Li ◽  
Fangxiao Lu ◽  
Lei Tao ◽  
Haifeng Yu ◽  
Xi Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
B Cell ◽  
Interstitial Pneumonia ◽  
Prophylactic Treatment ◽  
Significant Risk ◽  
Prophylactic Antibiotic ◽  
B Cell Lymphoma ◽  
Once Daily ◽  
Non Hodgkin Lymphoma ◽  
Associated Risk Factors

Abstract Background Several studies have reported the incidence of interstitial pneumonia (IP) among patients with non-Hodgkin lymphoma (NHL) that are undergoing combination chemotherapy plus rituximab; however, the effective prophylactic treatment for IP remains unclear. This study aims to explore the prophylactic effect of trimethoprim-sulfamethoxazole (TMP-SMX) on IP and identify IP-associated risk factors in NHL patients.Methods Between March 2013 and April 2018, 498 patients (264 males, 53%) with B-cell NHL undergoing first-line RCHOP-like chemotherapy treatment with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone were enrolled in this study.Results These patients had a median age of 56 years, and 311 of the 498 patients (62.4%) were administered once daily with the prophylactic treatment of TMP-SMX. IP occurred in 65 patients (13.1%), indicating a significant reduction in the IP incidence rate (21.4% vs. 8.0%; p<0.001). Among patients treated with TMP-SMX, 2 (1.2%) exhibited rashes, 38 (12.2%) suffered from nausea and vomiting, 52 (16.7%) showed signs of neutropenia, and 18 (5.8%) suffered from kidney dysfunction. Both univariate and multivariate analysis showed that gender (male), history of diabetes, and absence of prophylactic TMP-SMX treatment were significant risk factors associated with IP. Disease progression was observed in 55/311 (17.7%) patients that underwent prophylactic TMP-SMX treatment and in 63/187 (33.7%) patients that did not (p<0.001).Conclusions This study revealed that the occurrence of IP was common in B-cell NHL patients undergoing combined chemotherapy plus rituximab treatment. IP could be reduced with prophylactic treatment of once-daily oral TMP-SMX.

scholarly journals Prophylactic treatment with trimethoprim-sulfamethoxazole (TMP-SMX) decreased the incidence of interstitial pneumonia in B cell non-Hodgkin lymphoma patients receiving combined chemotherapy plus rituximab

2020 ◽  
Author(s):  
Cong Li ◽  
Fangxiao Lu ◽  
Lei Tao ◽  
Haifeng Yu ◽  
Xi Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Interstitial Pneumonia ◽  
Prophylactic Treatment ◽  
Significant Risk ◽  
Combined Chemotherapy ◽  
Once Daily ◽  
Non Hodgkin Lymphoma ◽  
Associated Risk Factors

Abstract Background Several studies have reported the incidence of interstitial pneumonia (IP) among patients with non-Hodgkin lymphoma (NHL) that are undergoing combination chemotherapy plus rituximab; however, the effective prophylactic treatment for IP remains unclear. This study aims to explore the prophylactic effect of trimethoprim-sulfamethoxazole (TMP-SMX) on IP and identify IP-associated risk factors in NHL patients.Methods Between March 2013 and April 2018, 498 patients (264 males, 53%) with B-cell NHL undergoing first-line RCHOP-like chemotherapy treatment with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone were enrolled in this study.Results These patients had a median age of 56 years, and 311 of the 498 patients (62.4%) were administered once daily with the prophylactic treatment of TMP-SMX. IP occurred in 65 patients (13.1%), indicating a significant reduction in the IP incidence rate (21.4% vs. 8.0%; p<0.001). Among patients treated with TMP-SMX, 2 (1.2%) exhibited rashes, 38 (12.2%) suffered from nausea and vomiting, 52 (16.7%) showed signs of neutropenia, and 18 (5.8%) suffered from kidney dysfunction. Both univariate and multivariate analysis showed that gender (male), history of diabetes, and absence of prophylactic TMP-SMX treatment were significant risk factors associated with IP. Disease progression was observed in 55/311 (17.7%) patients that underwent prophylactic TMP-SMX treatment and in 63/187 (33.7%) patients that did not (p<0.001).Conclusions This study revealed that the occurrence of IP was common in B-cell NHL patients undergoing combined chemotherapy plus rituximab treatment. IP could be reduced with prophylactic treatment of once-daily oral TMP-SMX.

scholarly journals Prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) decreases the incidence of interstitial pneumonia in B cell non- Hodgkin lymphoma patients receiving chemotherapy with rituximab

2019 ◽  
Author(s):  
Cong Li ◽  
Fangxiao Lu ◽  
Lei Tao ◽  
Haifeng Yu ◽  
Xi Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Interstitial Pneumonia ◽  
Significant Risk ◽  
Once Daily ◽  
High Risk Factors ◽  
Non Hodgkin Lymphoma ◽  
History Of ◽  
Prophylactic Use

Abstract Several studies have reported incidence of interstitial pneumonia (IP) among patients with non-hodgkin lymphoma (NHL) receiving chemotherapy with rituximab, however the best prophylaxis method remains unclear. This retrospective study was intended to identify the effect of prophylactic TMP-SMX once daily on IP and high risk factors effecting IP in patients with NHL. From March 2013 to April 2018, 498 patients (264 male, 53%) with B cell NHL receiving first-line CHOP-like chemotherapy with rituximab were enrolled in this study. The median age of the patients was 56 years old. Among these patients, 311 patients (62.4%) received prophylaxis of TMP-SMX. IP occurred in 65 patients, so the incidence rate of IP was 13.1%. The prophylactic use of TMP-SMX given one tablet daily could significantly decrease the rate of IP from 21.4% to 8.0% (p<0.001). For 311 patients with prophylactic TMP-SMX, 2 (1.2%) had rashes, 38 (12.2%) suffered nausea and vomiting, 52 (16.7%) exhibited neutropenia, and 18 (5.8%) suffered kidney dysfunction. Being male, having a history of diabetes and not receiving TMP-SMX prophylactic therapy were considered as statistically significant risk factors for IP in univariate and multivariate analysis. Disease progression was observed in 55/311 (17.7%) patients with prophylactic TMP-SMX and in 63/187 (33.7%) patients without prophylactic TMP-SMX treatment (p<0.001). The present study concluded that IP occurrence is not rare in B cell non-hodgkin lymphoma patients receiving chemotherapy with rituximab, while prophylaxis of oral TMP-SMX given one tablet daily significantly decreased incidence of IP.

scholarly journals Prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) decreases the incidence of interstitial pneumonia (IP) in B cell non-Hodgkin lymphoma (NHL) patients receiving chemotherapy with rituximab

2020 ◽  
Author(s):  
Cong Li ◽  
Fangxiao Lu ◽  
Lei Tao ◽  
Haifeng Yu ◽  
Xi Chen ◽  
...  
Keyword(s):  
B Cell ◽  
Hodgkin Lymphoma ◽  
Interstitial Pneumonia ◽  
Chemotherapy Treatment ◽  
First Line ◽  
Once Daily ◽  
Non Hodgkin Lymphoma ◽  
Study Results ◽  
History Of ◽  
Associated Risk Factors

Abstract Background Several studies have reported on the incidence of interstitial pneumonia (IP) among patients with non-Hodgkin lymphoma (NHL) that have been treated with chemotherapy plus rituximab, however, the best means of prophylactically preventing IP remains unclear. This retrospective study was designed to explore the prophylactic effect of trimethoprim-sulfamethoxazole (TMP-SMX) on IP and to identify IP-associated risk factors in NHL patients. Methods Between March 2013 and April 2018, 498 patients (264 male, 53%) with B cell NHL undergoing first-line rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP)-like chemotherapy treatment were enrolled in this study. Results These patients had a median age of 56 years, and 311 of these patients (62.4%) were administered prophylactic TMP-SMX. IP occurred in 65 patients (13.1%), with once daily prophylactic TMP-SMX treatment leading to a significant reduced IP rate (21.4% vs. 8.0%; p<0.001). Among patients treated with TMP-SMX, 2 (1.2%) exhibited rashes, 38 (12.2%) suffered from nausea and vomiting, 52 (16.7%) showed signs of neutropenia, and 18 (5.8%) suffered kidney dysfunction. Being male, having a history of diabetes, and not having undergone prophylactic TMP-SMX treatment were all found to be significantly associated with IP risk in both univariate and multivariate analysis. Disease progression was observed in 55/311 (17.7%) patients that underwent prophylactic TMP-SMX treatment and in 63/187 (33.7%) patients that did not (p<0.001). Conclusions Overall, these results reveal that IP is common in B cell NHL patients undergoing chemotherapy plus rituximab treatment, with the prophylactic administration of once daily oral TMP-SMX significantly reduces the IP incidence.

scholarly journals Clinical features, treatment and risk factors for interstitial pneumonia in B-cell non-Hodgkin lymphoma patients

2020 ◽  
Vol 9 (9) ◽  
pp. 5139-5146
Author(s):  
Cong Li ◽  
Fangxiao Lu ◽  
Tao Lei ◽  
Haifeng Yu ◽  
Haiyan Yang
Keyword(s):  
Risk Factors ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Interstitial Pneumonia ◽  
Clinical Features ◽  
Non Hodgkin Lymphoma

Risk Factor Analysis Of Non-Hodgkin Lymphoma-Associated Hemophagocytic Syndromes: A Multicenter Study

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1778-1778
Author(s):  
Hirozumi Sano ◽  
Ryoji Kobayashi ◽  
Junji Tanaka ◽  
Satoshi Hashino ◽  
Shuichi Ota ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Nk Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Patient Characteristics ◽  
Eb Virus ◽  
Non Hodgkin Lymphoma

Abstract Hemophagocytic lymphohistiocytosis (HLH) is often associated with malignant diseases, mainly B-cell or T/NK-cell lymphoma. However, to date, few studies have examined lymphoma-associated hemophagocytic syndrome (LAHS). Our aim was to clarify the risk factors and prognostic factors of LAHS. A total of 1,181 patients with non-Hodgkin lymphoma were analyzed at 12 institutions in Hokkaido prefecture between April 2007 and December 2011 to assess the incidence, prognosis, and risk factors of LAHS. To evaluate the risk factors for developing LAHS, patient characteristics including age, gender, and histopathology were compared between patients with and without LAHS. The cumulative incidence rate of LAHS was 3.0% (35/1,181). The mortality rate of patients with LAHS was 69% (24/35), which was significantly higher than that of patients without LAHS (29%, P<0.001). The frequency of LAHS was higher in patients with T/NK-cell lymphoma than in patients with B-cell lymphoma (11.6 vs 1.8%, P<0.001). No significant differences were observed in age or gender between patients with and without LAHS. Patient characteristics including age, gender, histopathology, clinical symptoms, treatment for LAHS, EB virus serology, and laboratory data were subsequently compared between alive and dead patients to evaluate the prognostic factor of LAHS. The results obtained showed that the mortality rate was significantly higher in patients with T/NK-cell lymphoma than in patients with B-cell lymphoma (88 vs 53%, P=0.035). The frequency of liver dysfunction, including elevated total bilirubin (T.Bil) and liver enzymes [glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT)], was higher in fatal cases than in alive cases (T.Bil, median 1.35mg/dl, range 0.6-12.7mg/dl vs median 0.9mg/dl, range 0.5-6.1mg/dl, P=0.069; GOT, median 85.5IU/L, range 16-1,076IU/L vs median 40.0IU/L, range 10-651IU/L, P=0.076; GPT, median 62.5IU/L, range 11-910IU/L vs median 31.0IU/L, range 6-362IU/L, P=0.038). Moreover, the mortality rate of patients who did not respond to initial treatments including corticosteroids was higher than that of good responders (95 vs 54%, P=0.049). EB virus serology had no significant clinical impact on the prognosis of LAHS. In conclusion, patients with T/NK-cell lymphoma showed not only higher complication rates of LAHS than those of patients with B-cell lymphoma, but also higher mortality rates after developing LAHS. Further preclinical and clinical studies are required to understand the detailed pathogenesis of LAHS and improve the prognosis of patients developing LAHS. Disclosures: No relevant conflicts of interest to declare.

Low Absolute Lymphocyte Count and Addition of Rituximab Confer High Risk for Interstitial Pneumonia In Patients with Diffuse Large B Cell Lymphoma

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1805-1805
Author(s):  
Yuan-Bin Yu ◽  
Yu-Chung Huang ◽  
Chia-Jen Liu ◽  
Jih-tung Pai ◽  
Hsueh-Ju Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
B Cell ◽  
Interstitial Pneumonia ◽  
Lymphocyte Count ◽  
Conflicts Of Interest ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Absolute Lymphocyte Count ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Abstract 1805 Purpose: Several studies reported pulmonary toxicities in patients with diffuse large B cell lymphoma (DLBCL) receiving rituximab and chemotherapy. This retrospective study aimed to determine the risk factors and clinical characteristics of interstitial pneumonia in patients with DLBCL. Methods: From January 2000 to May 2009, 529 consecutive patients with DLBCL receiving first-line COP- or CHOP-based chemotherapy with or without rituximab in Taipei Veterans General Hospital were enrolled. Interstitial pneumonia (IP) was defined as diffuse pulmonary interstitial infiltrates found on computed tomography scan as well as respiratory symptoms. Patient characteristics and outcome parameters were retrieved via medical chart review. Results: IP was observed in 26 patients (4.9%) and 6 of them were confirmed asPneumocystis jirovecii pneumonia. The median number of chemotherapy course to IP was 4 cycles (range, 1–7). By multivariate logistic regression, absolute lymphocyte count (ALC) less than 1×109/L before treatment (odds ratio [OR] 2.75, 95% confidence interval [CI] 1.23–6.19) and addition of rituximab to chemotherapy (OR 4.56, 95% CI 1.68–12.39) were identified as independent risk factors for IP. In the rituximab-treated patients, low ALC at baseline further increased the risk for IP. Conclusions: Incidence of IP is increased in patients with DLBCL receiving rituximab-containing chemotherapy. Specific subgroup with lymphopenia at diagnosis should receive more attention in detecting this pulmonary complication. Disclosures: No relevant conflicts of interest to declare.

Metody cytogenetyki molekularnej w różnicowaniu agresywnych B-NHL

2019 ◽  
Vol 50 (3) ◽  
pp. 109-115
Author(s):  
Beata Grygalewicz
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
World Health ◽  
High Grade ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
Health Organization ◽  
Large B Cell

StreszczenieB-komórkowe agresywne chłoniaki nieziarnicze (B-cell non-Hodgkin lymphoma – B-NHL) to heterogenna grupa nowotworów układu chłonnego, wywodząca się z obwodowych limfocytów B. Aberracje cytogenetyczne towarzyszące B-NHL to najczęściej translokacje onkogenów takich jak MYC, BCL2, BCL6 w okolice genowych loci dla łańcuchów ciężkich lub lekkich immunoglobulin. W niektórych przypadkach dochodzi do wystąpienia kilku wymienionych aberracji jednocześnie, tak jak w przypadkach przebiegających z równoczesną translokacją genów MYC i BCL2 (double hit), niekiedy także z obecnością rearanżacji BCL6 (triple hit). Takie chłoniaki cechuje szczególnie agresywny przebieg kliniczny. Obecnie molekularna diagnostyka cytogenetyczna przy użyciu techniki fluorescencyjnej hybrydyzacji in situ (FISH) oraz, w niektórych przypadkach, aCGH jest niezbędnym narzędziem rozpoznawania, klasyfikowania i oceny stopnia zaawansowania agresywnych, nieziarniczych chłoniaków B-komórkowych. Technika mikromacierzy CGH (aCGH) była kluczowym elementem wyróżnienia prowizorycznej grupy chłoniaków Burkitt-like z aberracją chromosomu 11q (Burkitt-like lymphoma with 11q aberration – BLL, 11q) w najnowszej klasyfikacji nowotworów układu chłonnego Światowej Organizacji Zdrowia (World Health Organization – WHO) z 2016 r. Omówione zostaną sposoby różnicowania na poziomie cytogenetycznym takich chłoniaków jak: chłoniak Burkitta (Burkitt lymphoma – BL), chłoniak rozlany z dużych komórek B (diffuse large B-cell lymphoma – DLBCL) oraz 2 nowych jednostek klasyfikacji WHO 2016, czyli chłoniaka z komórek B wysokiego stopnia złośliwości z obecnością translokacji MYC i BCL2 i/lub BCL6 (high-grade B-cell lymphoma HGBL, with MYC and BCL2 and/or BCL6 translocations) oraz chłoniaka BLL, 11q.

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