Annals of palliative medicine · 2021
Incidence and risk factors of pneumonia in diffuse large B-cell lymphoma patients receiving first line R-CHOP/R-CHOP-like immunochemotherapy: a retrospective study of 287 patients in single center.
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Wang Jingwen, Liu Fei, Tang Xi
Аннотация
BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) patients may develop pneumonia during immunochemotherapy. The purpose of this retrospective study was to determine the incidence of and risk factors for pneumonia.
METHODS: By retrospectively searching the hospital's computer-database, we reviewed the records of DLBCL patients who underwent the first-line rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)/R-CHOP-like immunochemotherapy at our institution from January 2012 to June 2019. Statistical analyses were conducted to calculate the odds ratio (OR) of characteristics and identify the risk factors of pneumonia for these patients.
RESULTS: In total, 287 DLBCL patients were recruited to this study. Among them, 84 (29.3%) patients developed pneumonia during treatment. The incidence of severe pneumonia was 19.4% (18/93) with a 33.3% mortality rate (6/18). Pneumonia was associated with inferior progression-free survival (PFS) [hazard ratio (HR) 1.78, 95% confidence interval (CI): 1.05 to 3.00, P=0.016]. Through multivariate logistic regression analysis, age (OR =1.030, 95% CI: 1.005 to 1.055), advanced stage (OR =2.176, 95% CI: 1.015 to 4.669), comorbidity of chronic kidney disease (CKD) (OR =11.794, 95% CI: 2.444 to 56.910), severe agranulocytosis (OR =8.777, 95% CI: 4.457 to 17.285), and pneumonia at onset (OR =9.548, 95% CI: 3.734 to 24.413) were identified as risk factors for pneumonia during the course of immunochemotherapy.
CONCLUSIONS: Pneumonia has a negative impact on survival in DLBCL patients receiving the first-line R-CHOP/R-CHOP-like regimen. For patients with risk factors, surveillance should be emphasized to prevent pneumonia.
METHODS: By retrospectively searching the hospital's computer-database, we reviewed the records of DLBCL patients who underwent the first-line rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)/R-CHOP-like immunochemotherapy at our institution from January 2012 to June 2019. Statistical analyses were conducted to calculate the odds ratio (OR) of characteristics and identify the risk factors of pneumonia for these patients.
RESULTS: In total, 287 DLBCL patients were recruited to this study. Among them, 84 (29.3%) patients developed pneumonia during treatment. The incidence of severe pneumonia was 19.4% (18/93) with a 33.3% mortality rate (6/18). Pneumonia was associated with inferior progression-free survival (PFS) [hazard ratio (HR) 1.78, 95% confidence interval (CI): 1.05 to 3.00, P=0.016]. Through multivariate logistic regression analysis, age (OR =1.030, 95% CI: 1.005 to 1.055), advanced stage (OR =2.176, 95% CI: 1.015 to 4.669), comorbidity of chronic kidney disease (CKD) (OR =11.794, 95% CI: 2.444 to 56.910), severe agranulocytosis (OR =8.777, 95% CI: 4.457 to 17.285), and pneumonia at onset (OR =9.548, 95% CI: 3.734 to 24.413) were identified as risk factors for pneumonia during the course of immunochemotherapy.
CONCLUSIONS: Pneumonia has a negative impact on survival in DLBCL patients receiving the first-line R-CHOP/R-CHOP-like regimen. For patients with risk factors, surveillance should be emphasized to prevent pneumonia.