2337. Incidence of Infectious Complications in Patients with Non-Hodgkin Lymphoma Receiving Rituximab-containing Chemotherapy
Session: Poster Abstract Session: Infections in the Compromised Host
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • poster IDWeek_1.pdf (706.7 kB)
  • Background:

    Rituximab, a monoclonal antibody against CD20+ cells, produces a fast depletion of B cells. It also has citotoxic effects on T cells, late-onset neutropenia and hypoggamaglobulinemia. It increases the risk of hepatitis B reactivation and has also been associated to the development of opportunistic infections.

    Methods:

    Retrospective, single-center, observational and analytical study that included patients diagnosed with non-Hodgkin lymphoma (NHL) from January 1, 2011 to December 31, 2012 at Instituto Nacional de Cancerología (INCan) in Mexico City. Demographics, outcomes and infections grade 3 to 5 (Common Terminology Criteria for Adverse Events version 4.0, NCI, NIH) were registered on a standardized data form. Infectious complications were described and incidence was calculated.

    Results:

    Two-hundred and sixty-five patients with NHL were included, 85 (32%) developed an infectious complication, infection rate 0.87 per 1000 person/days. There were 177 events in the 85 patients. Forty-two patients (49%) had more than one event. Most common infections were: febrile neutropenia (n=38, 21.5%); mucosal barrier injury related (n=28, 15.8%); urinary tract infections (n=19, 10.7%); pneumonia (n=38, 21.5%); skin and soft tissue infections (n=17, 9.6%); abdominal sepsis (n=12, 6.8%); central line-associated bloodstream infection (n=16, 9%) and meningitis (n=2, 1.1%). In 88 (49%) of the events there was a microbiologic diagnosis: 70 (39.5%) bacteria, 4 (2.3%) mycobacterium, 4 (2.3%) fungus, 9 (5.1%) virus and 1 (0.6%) parasite. The incidence rate of tuberculosis (TB) was 721 per 100000 person/years. There were no hepatitis B reactivations although there were 6 patients with anti-core antibodies positive that do not received preemptive antiviral treatment. The median hospital-stay for patients with an infection event was 6 (1-58) days. Thirty-five events (19.7%) contributed directly to death; pneumonia accounted for 14 (40%) of these events.

    Conclusion:

    The incidence rate of TB in this population was 41 times higher than that reported in the general population in Mexico. Strategies must be implemented to diagnose and treat latent TB and to include amongst the differential diagnosis TB, favoring an appropriate and early treatment.

    Patricia Meza-Meneses, MD1, Diana Vilar-Compte, MD, MSc2, Patricia Cornejo-Juarez, MD, MSc2 and Patricia Volkow, MD3, (1)Infectious Diseases, Hospital Regional de Alta Especialidad Ixtapaluca, Estado de MĂ©xico, Mexico, (2)Infectious Diseases, Instituto Nacional de CancerologĂ­a, Mexico City, Mexico, (3)Infectious Diseases Department, Instituto Nacional de Cancerologia, Mexico City, Mexico

    Disclosures:

    P. Meza-Meneses, None

    D. Vilar-Compte, None

    P. Cornejo-Juarez, None

    P. Volkow, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.