Chemotherapy-related infectious complications in patients with Hematologic malignancies

The objective of the present study was to determine the association between chemotherapy and infectious complications in patients diagnosed with Hematologic malignancies (HMs).

The study included 463 patients diagnosed with HMs multiple myeloma (MM), Hodgkin's lymphoma (HL), non-HL (NHL), acute myeloid leukemia (AML), acute lymphocytic leukemia, chronic lymphocytic leukemia, and chronic myeloid leukemia, between January 2014 and June 2015. The patients were followed for 1 year after inclusion, to record the infectious complications. The collected data included age, sex, type of chemotherapy regimen, and several blood tests at admission. All patients received prophylactic treatment with antibiotics and antifungal agents. For each infection, we recorded the microbiological diagnosis and the day of occurrence since HMs diagnosis.

In patients with MM, we found that the treatment with growth factors (hazard ratio [HR] 2.2; confidence interval [CI] 95%: 1-4.6; P = 0.03) was associated with a higher chance of infectious complications. In patients with non-Hodgkin lymhoma (LNH), the following drugs were associated with a higher infectious incidence: cytarabine (HR: 2.3; CI 95%: 1-5; P = 0.03), methotrexate (HR: 2.1; CI 95%: 1.8-4; P = 0.01), dexamethasone (HR: 1.7; CI 95%: 0.9-3; P = 0.06), growth factors (HR: 1.7; CI 95%: 0.9-3.2; P = 0.001), and etoposide (HR: 2.5; CI 95%: 1.5-4.2; P = 0.002). Cytarabine (induction) (HR: 2; CI 95%: 1.1-3.7; P = 0.01), cytarabine (consolidation) (HR: 2.1; CI 95%: 1.3-3.5; P = 0.01), and growth factors (HR: 2.1; CI 95%: 1.3-3.5; P = 0.002) were often on the therapeutic plan of patients with AML, which developed infections.

Regarding the chemotherapy regimen, the highest incidences of infectious complications were observed for growth factors and cytarabine.