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感染负担:成熟 B 细胞恶性肿瘤诊断后伴和不伴继发免疫缺陷病患者。

Burden of Infection in Patients With and Without Secondary Immunodeficiency Disease Following Diagnosis of a Mature B Cell Malignancy.

机构信息

Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY.

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.

出版信息

Clin Lymphoma Myeloma Leuk. 2024 Aug;24(8):553-563. doi: 10.1016/j.clml.2024.04.002. Epub 2024 Apr 10.

Abstract

BACKGROUND

This retrospective cohort study compared patient characteristics and burden of infection in patients with mature B cell malignancies with and without secondary immunodeficiency disease (SID).

PATIENTS AND METHODS

Data were extracted from the Humedica database (H-DB) and Guardian Research Network (GRN) database from October 1, 2015 to March 10, 2020, including a 6-month pre-index period (PIP) and 12-month follow-up. Patients aged ≥18 years diagnosed with chronic lymphocytic leukemia/small lymphocytic lymphoma, multiple myeloma, or non-Hodgkin's lymphoma in the PIP were stratified into 2 cohorts: SID (hypogammaglobulinemia [using ICD-10-CM codes] or serum IgG levels <5.0 g/L, both with signs and symptoms of SID or at least 1 infection) and no-SID. Patients with SID or primary immunodeficiency diseases in the PIP were excluded.

RESULTS

Overall, 2221 patients with SID (H-DB/GRN: n = 1959/262), and 19,141 patients without SID (n = 17,598/1543) were included. Baseline characteristics were similar across cohorts. At 12-month follow-up, significantly more patients with SID had experienced ≥1 infection and ≥1 severe bacterial infection than those without SID (both P < .001). H-DB/GRN mean (standard deviation) number of severe bacterial infections was 7.6 (9.9)/2.9 (2.7) for the SID cohort versus 5.2 (6.8)/2.4 (2.2) for the no-SID cohort.

CONCLUSION

This study confirms that patients with mature B cell malignancies and SID face a significantly higher burden of infections than those without SID.

摘要

背景

本回顾性队列研究比较了伴有和不伴有继发性免疫缺陷病(SID)的成熟 B 细胞恶性肿瘤患者的患者特征和感染负担。

患者和方法

数据从 Humedica 数据库(H-DB)和 Guardian Research Network(GRN)数据库中提取,时间为 2015 年 10 月 1 日至 2020 年 3 月 10 日,包括 6 个月的索引前时期(PIP)和 12 个月的随访。在 PIP 中诊断为慢性淋巴细胞白血病/小淋巴细胞淋巴瘤、多发性骨髓瘤或非霍奇金淋巴瘤且年龄≥18 岁的患者分为 2 个队列:SID(低丙种球蛋白血症[使用 ICD-10-CM 代码]或血清 IgG 水平<5.0g/L,均伴有 SID 的体征和症状或至少 1 种感染)和非 SID。PIP 中患有 SID 或原发性免疫缺陷病的患者被排除在外。

结果

总体而言,2221 例 SID 患者(H-DB/GRN:n=1959/262)和 19141 例非 SID 患者(n=17598/1543)纳入研究。各队列间基线特征相似。在 12 个月的随访中,SID 组有显著更多的患者经历了≥1 次感染和≥1 次严重细菌感染,而非 SID 组(均<0.001)。H-DB/GRN 中 SID 队列的严重细菌感染平均(标准差)次数为 7.6(9.9)/2.9(2.7),而非 SID 队列为 5.2(6.8)/2.4(2.2)。

结论

本研究证实,伴有成熟 B 细胞恶性肿瘤和 SID 的患者面临着显著更高的感染负担,而非 SID 患者。

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