Lymphoma: highly immunosuppressive chemo tied to 3-fold HZ risk

  • Vázquez YG, et l.
  • Clin Lymphoma Myeloma
  • 12 déc. 2018

  • Par David Reilly
  • Résumés d'articles
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Takeaway

  • Patients with lymphoma are at increased risk of developing herpes zoster (HZ).
  • Prophylaxis should be considered, especially in those with risk factors identified in the study.

Why this matters

  • Patients with cancer are at increased risk of developing HZ; patients with hematologic malignancies are at greater risk than patients with solid tumors.

Study design

  • Study to identify risk factors for developing HZ in 415 adult patients with lymphoma.
  • Data were sourced from the Auxilio Mutuo Cancer Center (AMCC) registry.
  • Median patient age at diagnosis, 67 years.
  • Funding: National Center for Minority Health and Health Disparities; National Institutes of Health.

Key results

  • 46 cases of HZ identified at 8.9 years' median follow-up.
  • Increased HZ incidence was associated with factors including:
    • multiple chemotherapy courses (P=.035),
    • stage at diagnosis (advanced vs localized; P=.034),
    • presentation (indolent vs aggressive; P=.030),
    • highly immunosuppressive chemotherapy (with vs without; P<.001 and>
    • lymphocytopenia (defined as baseline absolute lymphocyte count
  • In multivariate analysis, patients receiving highly immunosuppressive chemotherapy had 2.9 times the risk of developing HZ (relative risk, 2.88; 95% CI, 1.47-5.623).

Limitations

  • Patients with mild symptoms of HZ may not have been identified.
  • Retrospective data.