Herpesviridae viral infections following rituximab combined chemotherapy in patients with diffuse large B-cell lymphoma

摘要

Background: Herpesviridae viral infections (HVIs) are particularly common in patients with hematologic malignancies after undergoing hematopoietic stem cell transplantation or receiving chemotherapy. However, there have been few reports on the incidence and risk factors of HVIs in diffuse large B-cell lymphoma (DLBL) patients treated with rituximab combined chemotherapy. Methods: We analyzed 270 patients who were newly diagnosed with DLBL. All of the patients had received rituximab combined chemotherapy between June 2004 and April 2010. Results: Twenty-nine patients (10.7%) developed HVI a median of 5.57 months (range 0.37-30.03) after initial chemotherapy. The estimated cumulative incidence rates of HVIs were 8.3 and 12.8% at 1 and 3 years, respectively, in all patients. Independent risk factors for HVIs were a high international prognostic index risk [p = 0.017, hazard ratio (HR) 2.633, 95% confidence interval (CI) 1.185-5.850], neutropenic fever (p = 0.023, HR 2.476, 95% CI 1.134-5.406) and a high cumulative dose of steroids (p = 0.023, HR 2.921, 95% CI 1.162-7.346). Conclusion: A high international prognostic index risk, neutropenic fever and a high cumulative dose of steroids appear to be risk factors for HVI in DLBL patients who are undergoing rituximab combined chemotherapy.