Characteristics of pulmonary complications in non-Hodgkin’s lymphoma patients treated with rituximab-containing chemotherapy and impact on survival
| Autor: | Jiangang (Jason) Liao, Jeffrey Sivik, Kimberly Keefer, Regis Bender, Andry Van de Louw |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty ARDS Lymphoma Exacerbation Pneumocystis carinii Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Mortality Survival rate Aged Retrospective Studies Respiratory complications Lung business.industry Lymphoma Non-Hodgkin Pneumonia Pneumocystis Hazard ratio Hematology General Medicine Middle Aged medicine.disease Non-Hodgkin's lymphoma Survival Rate medicine.anatomical_structure 030220 oncology & carcinogenesis Original Article Female Rituximab business Complication 030215 immunology medicine.drug |
| Zdroj: | Annals of Hematology |
| ISSN: | 1432-0584 0939-5555 |
| DOI: | 10.1007/s00277-018-3448-9 |
| Popis: | Patients with non-Hodgkin's lymphoma (NHL) receiving rituximab-containing chemotherapy are at risk of developing respiratory complications, but comprehensive information on these complications and their impact on survival is lacking. We performed a retrospective cohort analysis on 123 NHL patients who received rituximab-containing chemotherapy between 2009 and 2016 in order to describe the incidence, etiologies and effect on survival of respiratory complications defined by new or worsening respiratory symptoms requiring diagnostic work-up or hospitalization. Thirty patients (24%) developed respiratory complications during a follow-up time of 825 (555-1338) days after chemotherapy. They had a higher prevalence of congestive heart failure and lung or pleural involvement at diagnosis as compared to patients who did not develop complications. Overall, 58 episodes of pulmonary complications were observed after median (interquartile) times from the first and last rituximab doses of 205 (75-580) days and 27 (14-163) days respectively. Infectious etiologies accounted for 75% of the respiratory complications, followed by heart failure exacerbation, lymphomatous involvement, and ARDS. Two Pneumocystis jirovecii pneumonias were observed, and no complication was ascribed to rituximab toxicity. Respiratory complications required ICU admission in 19 cases (33%) and invasive mechanical ventilation in 14 cases (24%). Using a time-dependent Cox regression analysis, we observed that the occurrence of respiratory complications was associated with a 170% increase in death hazard (hazard ratio 2.65, 95% CI 1.60-4.40, p = 0.001). In conclusion, respiratory complications in NHL patients receiving chemotherapy are relatively frequent, severe, and mostly infectious and are associated with increased mortality. |
| Databáze: | OpenAIRE |
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