Cryptococcus neoformans infections in patients with lymphoproliferative neoplasms.

Cryptococcosis is a rare opportunistic infection increasingly associated with lymphoproliferative disorders. The clinical course and outcomes in these patients have not been extensively studied. We retrospectively reviewed charts of adult patients with lymphoproliferative disorders diagnosed with cryptococcal infections. A total of 34 patients were identified; 31 (91%) had a B-cell neoplasm and 3 (9%) had a T-cell neoplasm. The most frequent clinical syndrome was disseminated cryptococcal infection (38%), followed by pneumonia (29%). 74% received prior chemotherapy and the overall mortality in this group was nearly six-fold higher than chemotherapy naïve patients; 26% were chemotherapy naïve. After a median follow-up of nine months from the date of infection, 24 patients had died (71%). The overall mortality at 30-days and one year was 18% and 46%, respectively. The high mortality warrants future studies to identify those at highest risk. Clinicians should remain vigilant as early diagnosis and treatment are of utmost importance.