J Korean Med Sci.  2012 Dec;27(12):1468-1471. 10.3346/jkms.2012.27.12.1468.

Risk Factors for Febrile Neutropenia during Chemotherapy for HIV-Related Lymphoma

• Park J
• Kim TM
• Hwang JH
• Kim NH
• Choe PG
• Song KH
• Kim ES
• Park SW
• Kim HB
• Kim NJ
• Park WB
• Oh MD

• KMID: 2157968
• DOI: http://doi.org/10.3346/jkms.2012.27.12.1468

Abstract

We evaluated risk factors for neutropenic fever and febrile prolonged neutropenia during vincristine-including chemotherapy to treat HIV-related lymphoma to investigate whether protease inhibitor (PI) treatment is associated with infectious complications due to drug interactions with chemotherapeutic agents. We included all HIV patients who received chemotherapy including vincristine for lymphoma at a single referral center in 1999-2010. Neutropenic fever was defined as absolute neutrophil count < 500 cells/microL with body temperature over 38degrees C; and prolonged neutropenia was defined if it persisted over 7 days. CODOX-M/IVAC and Stanford regimens were considered high-risk regimens for prolonged neutropenia. We analyzed 48 cycles of chemotherapy in 17 HIV patients with lymphoma. There were 22 neutropenic fever and 12 febrile prolonged neutropenia events. In multivariate analysis, neutropenic fever was associated with old age and low CD4 cell count, but not with PI use or ritonavir-boosted PI use. Low CD4 cell count and high-risk regimens were associated with febrile prolonged neutropenia. Neutropenic fever and febrile prolonged neutropenia is associated with old age, low CD4 cell count, and high-risk regimens, but not PI use, in HIV patients undergoing chemotherapy including vincristine for lymphoma.

Keyword

Human Immunodeficiency Virus; Lymphoma; Neutropenia

MeSH Terms

Adult
Age Factors
Antineoplastic Agents, Phytogenic/*therapeutic use
Body Temperature
CD4 Lymphocyte Count
Fever/*etiology
HIV Infections/complications
Humans
Lymphoma, AIDS-Related/complications/*drug therapy/pathology
Male
Middle Aged
Multivariate Analysis
Neutropenia/*etiology
Retrospective Studies
Risk Factors
Vincristine/*therapeutic use
Antineoplastic Agents, Phytogenic
Vincristine

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