Prophylactic antibiotic treatment with TMP-SMX decreased the incidence of interstitial pneumonia in patients with B-cell lymphoma on chemotherapy
Abstract Background Several studies have reported the incidence of interstitial pneumonia (IP) among patients with non-Hodgkin lymphoma (NHL) that are undergoing combination chemotherapy plus rituximab; however, the effective prophylactic treatment for IP remains unclear. This study aims to explore...
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| Format: | Article |
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BMC
2020-08-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-020-07254-w |
| _version_ | 1818326806161260544 |
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| author | Cong Li Fangxiao Lu Tao Lei Haifeng Yu Xi Chen Shuailing Peng Shuiyun Han Haiyan Yang |
| author_facet | Cong Li Fangxiao Lu Tao Lei Haifeng Yu Xi Chen Shuailing Peng Shuiyun Han Haiyan Yang |
| author_sort | Cong Li |
| collection | DOAJ |
| description | Abstract Background Several studies have reported the incidence of interstitial pneumonia (IP) among patients with non-Hodgkin lymphoma (NHL) that are undergoing combination chemotherapy plus rituximab; however, the effective prophylactic treatment for IP remains unclear. This study aims to explore the prophylactic effect of trimethoprim-sulfamethoxazole (TMP-SMX) on IP and identify IP-associated risk factors in NHL patients. Methods Between March 2013 and April 2018, 498 patients (264 males, 53%) with B-cell NHL undergoing first-line RCHOP-like chemotherapy treatment with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone were enrolled in this study. Results These patients had a median age of 56 years, and 311 of the 498 patients (62.4%) were administered once daily with the prophylactic treatment of TMP-SMX. IP occurred in 65 patients (13.1%), indicating a significant reduction in the IP incidence rate (21.4% vs. 8.0%; p < 0.001). Among patients treated with TMP-SMX, 2 (1.2%) exhibited rashes, 38 (12.2%) suffered from nausea and vomiting, 52 (16.7%) showed signs of neutropenia, and 18 (5.8%) suffered from kidney dysfunction. Both univariate and multivariate analysis showed that gender (male), history of diabetes, and absence of prophylactic TMP-SMX treatment were significant risk factors associated with IP. Disease progression was observed in 55/311 (17.7%) patients that underwent prophylactic TMP-SMX treatment and in 63/187 (33.7%) patients that did not (p < 0.001). Conclusions This study revealed that the occurrence of IP was common in B-cell NHL patients undergoing combined chemotherapy plus rituximab treatment. IP could be reduced with prophylactic treatment of once-daily oral TMP-SMX. |
| first_indexed | 2024-12-13T12:06:13Z |
| format | Article |
| id | doaj.art-87ecd42efbeb4855a7ce633219e006b8 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-13T12:06:13Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-87ecd42efbeb4855a7ce633219e006b82022-12-21T23:46:58ZengBMCBMC Cancer1471-24072020-08-012011710.1186/s12885-020-07254-wProphylactic antibiotic treatment with TMP-SMX decreased the incidence of interstitial pneumonia in patients with B-cell lymphoma on chemotherapyCong Li0Fangxiao Lu1Tao Lei2Haifeng Yu3Xi Chen4Shuailing Peng5Shuiyun Han6Haiyan Yang7Department of Medical Oncology, Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of SciencesDepartment of Medical Imaging, Zhejiang Cancer HospitalDepartment of Medical Oncology, Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of SciencesDepartment of Medical Oncology, Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of SciencesDepartment of Medical Oncology, Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of SciencesDepartment of Medical Oncology, Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of SciencesDepartment of Medical Oncology, Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of SciencesDepartment of Medical Oncology, Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of SciencesAbstract Background Several studies have reported the incidence of interstitial pneumonia (IP) among patients with non-Hodgkin lymphoma (NHL) that are undergoing combination chemotherapy plus rituximab; however, the effective prophylactic treatment for IP remains unclear. This study aims to explore the prophylactic effect of trimethoprim-sulfamethoxazole (TMP-SMX) on IP and identify IP-associated risk factors in NHL patients. Methods Between March 2013 and April 2018, 498 patients (264 males, 53%) with B-cell NHL undergoing first-line RCHOP-like chemotherapy treatment with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone were enrolled in this study. Results These patients had a median age of 56 years, and 311 of the 498 patients (62.4%) were administered once daily with the prophylactic treatment of TMP-SMX. IP occurred in 65 patients (13.1%), indicating a significant reduction in the IP incidence rate (21.4% vs. 8.0%; p < 0.001). Among patients treated with TMP-SMX, 2 (1.2%) exhibited rashes, 38 (12.2%) suffered from nausea and vomiting, 52 (16.7%) showed signs of neutropenia, and 18 (5.8%) suffered from kidney dysfunction. Both univariate and multivariate analysis showed that gender (male), history of diabetes, and absence of prophylactic TMP-SMX treatment were significant risk factors associated with IP. Disease progression was observed in 55/311 (17.7%) patients that underwent prophylactic TMP-SMX treatment and in 63/187 (33.7%) patients that did not (p < 0.001). Conclusions This study revealed that the occurrence of IP was common in B-cell NHL patients undergoing combined chemotherapy plus rituximab treatment. IP could be reduced with prophylactic treatment of once-daily oral TMP-SMX.http://link.springer.com/article/10.1186/s12885-020-07254-wB-cell lymphomaChemotherapyInterstitial pneumoniaTMP-SMXRituximab |
| spellingShingle | Cong Li Fangxiao Lu Tao Lei Haifeng Yu Xi Chen Shuailing Peng Shuiyun Han Haiyan Yang Prophylactic antibiotic treatment with TMP-SMX decreased the incidence of interstitial pneumonia in patients with B-cell lymphoma on chemotherapy BMC Cancer B-cell lymphoma Chemotherapy Interstitial pneumonia TMP-SMX Rituximab |
| title | Prophylactic antibiotic treatment with TMP-SMX decreased the incidence of interstitial pneumonia in patients with B-cell lymphoma on chemotherapy |
| title_full | Prophylactic antibiotic treatment with TMP-SMX decreased the incidence of interstitial pneumonia in patients with B-cell lymphoma on chemotherapy |
| title_fullStr | Prophylactic antibiotic treatment with TMP-SMX decreased the incidence of interstitial pneumonia in patients with B-cell lymphoma on chemotherapy |
| title_full_unstemmed | Prophylactic antibiotic treatment with TMP-SMX decreased the incidence of interstitial pneumonia in patients with B-cell lymphoma on chemotherapy |
| title_short | Prophylactic antibiotic treatment with TMP-SMX decreased the incidence of interstitial pneumonia in patients with B-cell lymphoma on chemotherapy |
| title_sort | prophylactic antibiotic treatment with tmp smx decreased the incidence of interstitial pneumonia in patients with b cell lymphoma on chemotherapy |
| topic | B-cell lymphoma Chemotherapy Interstitial pneumonia TMP-SMX Rituximab |
| url | http://link.springer.com/article/10.1186/s12885-020-07254-w |
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