Infection is an Independent Predictor of Death in Diffuse Large B Cell Lymphoma
AuthorDendle, C; Gilbertson, M; Spelman, T; Stuart, RL; Korman, TM; Thursky, K; Opat, S; McQuilten, Z
Source TitleScientific Reports
PublisherNATURE PUBLISHING GROUP
Surgery (St Vincent's)
Document TypeJournal Article
CitationsDendle, C., Gilbertson, M., Spelman, T., Stuart, R. L., Korman, T. M., Thursky, K., Opat, S. & McQuilten, Z. (2017). Infection is an Independent Predictor of Death in Diffuse Large B Cell Lymphoma. SCIENTIFIC REPORTS, 7 (1), https://doi.org/10.1038/s41598-017-04495-x.
Access StatusOpen Access
Open Access at PMChttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC5493675
To identify risk factors for infection in patients with diffuse large B cell lymphoma (DLBCL) undergoing rituximab, cyclophosphamide, vincristine, adriamycin and prednisolone (R-CHOP) treatment. All patients with DLBCL who received R-CHOP from 2004-2014 in a tertiary Australian hospital were identified and information collected from hospital admission data, laboratory results and medical record review. Infection was defined as hospitalisation with an ICD-10-AM diagnostic code for infection. Risk factors for infection and association between infection and survival were modelled using Cox proportional hazards regression. Over the 10-year period there were 325 patients; 191 (58.8%) males, median age 66 years. 206 (63.4%) patients experienced ≥1 infection. Independent predictors of infection were Charlson comorbidity index score (hazard ratio [HR] 3.60, p = 0.002), Eastern Cooperative Oncology Group (ECOG) performance status (HR 2.09 p = <0.001) and neutropenia (HR 2.46, p = <0.001). 99 (31%) patients died. Infection was an independent predictor of survival (HR 3.27, p = <0.001, as were age (HR 2.49, p = 0.001), Charlson comorbidity index (HR 4.34, p = <0.001), ECOG performance status (HR 4.33, p = 0.045) and neutropenia (HR 1.95, p = 0.047). Infections are common and infection itself is an independent predictor of survival. Patients at highest risk of infection and death are those with multiple comorbidities, poor performance status and neutropenia.
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