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Higher fungal infection rate in elderly patients (more than 80 years old) suffering from diffuse large B cell lymphoma and treated with rituximab plus CHOP

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Abstract

Although adding rituximab to standard cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy is an efficacious and well-tolerated regimen in elderly patients with diffuse large B cell lymphoma (DLBCL), it may increase susceptibility to opportunistic infections, and such cases have been reported. Our study was to identify the risk factors for fungal infection in a retrospective case-control matched study of 34 elderly DLBCL patients treated with rituximab plus CHOP (R-CHOP) and 35 control patients treated with the standard CHOP regimen at the Taipei Veterans General Hospital, Taiwan. The rate of overall infection was similar in both groups. However, subgroup analysis found that the fungal infection rate was significantly different, 41.7 and 17.1%, in the R-CHOP and CHOP groups, respectively, (P = 0.03). Univariate analysis identified the rituximab plus CHOP chemotherapy regimen (P = 0.03), age older than 80 years (P = 0.04), and bone marrow involvement (P = 0.04) as risk factors for development of fungal infection, whereas, multivariate regression analysis identified only rituximab plus CHOP and old age. Adding rituximab to the standard CHOP regimen in elderly DLBCL patients might increase the incidence of fungal infection especially in those older than 80 years old.

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Acknowledgments

We greatly thank the Taiwan Cancer Foundation and Taipei Veterans General Hospital for their grant support in this study.

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Authors and Affiliations

  1. Division of Hematology & Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Peng-Chan Lin, Liang-Tsai Hsiao, Say-Bee Poh, Wei-Shu Wang, Chueh-Chuan Yen, Ta-Chung Chao, Jin-Hwang Liu, Tzeon-Jye Chiou & Po-Min Chen

  2. National Yang-Ming University, School of Medicine, Taipei, Taiwan

    Peng-Chan Lin, Liang-Tsai Hsiao, Say-Bee Poh, Wei-Shu Wang, Chueh-Chuan Yen, Ta-Chung Chao, Jin-Hwang Liu, Tzeon-Jye Chiou & Po-Min Chen

  3. Division of Hematology & Oncology, Department of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan

    Peng-Chan Lin

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  1. Peng-Chan Lin
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  2. Liang-Tsai Hsiao
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Correspondence to Po-Min Chen.

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Lin, PC., Hsiao, LT., Poh, SB. et al. Higher fungal infection rate in elderly patients (more than 80 years old) suffering from diffuse large B cell lymphoma and treated with rituximab plus CHOP. Ann Hematol 86, 95–100 (2007). https://doi.org/10.1007/s00277-006-0191-4

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  • DOI: https://doi.org/10.1007/s00277-006-0191-4

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