INFECTIONS IN PATIENTS WITH LYMPHOMAS AND CHRONIC LYMPHOCYTIC LEUKEMIA AND THE ROLE OF IMMUNOGLOBULIN REPLACEMENT THERAPY – A RETROSPECTIVE COHORT ANALYSIS IN A CANCER CENTER
- 1A.C. Camargo Cancer Center, São Paulo, SP, Brazil
Abstract
Background: Infectious diseases are a leading cause of morbimortality in patients with B and T cell lymphomas and chronic lymphocytic leukemia (CLL). The aim of this study is to identify the main risk factors for infections in this population, as well as the role of immunoglobulin replacement therapy (IRT). Methods: A retrospective observational study in a population of patients with B and T cell lymphomas and CLL, treated at AC Camargo Cancer Center between January 2019 and December 2024. The primary objective was to determine the incidence and risk factors for infection and the role of IRT, with a secondary objective to determine the incidence of infection by ethological agent and overall survival. Results: A total of 112 patients with lymphomas and CLL were analyzed, and 290 infectious episodes were documented. Most patients experienced up to 4 infections (n = 130), and most of them occurred after 12-months of diagnosis and treatment (n = 64). In the multivariate analysis, independent risk factors for infection included diagnosis of diffuse large B-cell lymphoma (DLBCL) (HR = 4.75; 95% CI 1.60‒14.10; p = 0.005) and T-cell lymphoma (HR = 12.92; 95% CI 2.37‒70.40; p = 0.003), as well as exposure to anti-CD20 combined with cytotoxic chemotherapy at first-line therapy (HR = 4.70; 95% CI 1.46‒14.96; p = 0.009). Severe infections (grade ≥ 3) showed a higher proportion of microbiologically documented C. infections (50% vs. 28.3%; p < 0.001), viral infections (41.8% vs. 19.9%; p < 0.001), particularly by CMV (4.9% vs. 0%; p = 0.013), bacterial infections (15.8% vs. 6.6%; p = 0.031), and febrile neutropenia (15.7% vs. 2.2%; p < 0.001). The group receiving IRT showed significant differences in treatment patterns, including higher maintenance use of anti-CD20 (50% vs. 13%; p<0.001) and BTK inhibitors (22% vs. 0%; p<0.001), with no differences in the need for hospitalization or mortality. Conclusion: Infections predominantly occurred >12-months after diagnosis, reflecting cumulative immunosuppression and highlighting the need for improved strategies to prevent late infectious morbidity. IRT did not confer a survival advantage in this cohort; however, potential benefits in clinically relevant endpoints ‒ such as reductions in grade ≥3 infections and quality-of-life improvement ‒ remain unassessed and should be prioritized in future studies.
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BibTeX
@article{aith2026infections,
title = {{INFECTIONS IN PATIENTS WITH LYMPHOMAS AND CHRONIC LYMPHOCYTIC LEUKEMIA AND THE ROLE OF IMMUNOGLOBULIN REPLACEMENT THERAPY – A RETROSPECTIVE COHORT ANALYSIS IN A CANCER CENTER}},
author = {Julia AITH and Giovanna PERUZINI and Julia CURI and Luciana BRANDÃO and Talita SILVEIRA and Thaís FISCHER and Jayr SCHIMIDT- FILHO and Marjorie Vieira BATISTA},
journal = {Hematology, Transfusion and Cell Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.htct.2026.106790},
url = {https://doi.org/10.1016/j.htct.2026.106790},
note = {CC BY},
}
RIS
TY - JOUR
TI - INFECTIONS IN PATIENTS WITH LYMPHOMAS AND CHRONIC LYMPHOCYTIC LEUKEMIA AND THE ROLE OF IMMUNOGLOBULIN REPLACEMENT THERAPY – A RETROSPECTIVE COHORT ANALYSIS IN A CANCER CENTER
AU - Julia AITH
AU - Giovanna PERUZINI
AU - Julia CURI
AU - Luciana BRANDÃO
AU - Talita SILVEIRA
AU - Thaís FISCHER
AU - Jayr SCHIMIDT- FILHO
AU - Marjorie Vieira BATISTA
PY - 2026
DA - 2026/10/23
JO - Hematology, Transfusion and Cell Therapy
DO - 10.1016/j.htct.2026.106790
UR - https://doi.org/10.1016/j.htct.2026.106790
AB - Background: Infectious diseases are a leading cause of morbimortality in patients with B and T cell lymphomas and chronic lymphocytic leukemia (CLL). The aim of this study is to identify the main risk factors for infections in this population, as well as the role of immunoglobulin replacement therapy (IRT). Methods: A retrospective observational study in a population of patients with B and T cell lymphomas and CLL, treated at AC Camargo Cancer Center between January 2019 and December 2024. The primary objective was to determine the incidence and risk factors for infection and the role of IRT, with a secondary objective to determine the incidence of infection by ethological agent and overall survival. Results: A total of 112 patients with lymphomas and CLL were analyzed, and 290 infectious episodes were documented. Most patients experienced up to 4 infections (n = 130), and most of them occurred after 12-months of diagnosis and treatment (n = 64). In the multivariate analysis, independent risk factors for infection included diagnosis of diffuse large B-cell lymphoma (DLBCL) (HR = 4.75; 95% CI 1.60‒14.10; p = 0.005) and T-cell lymphoma (HR = 12.92; 95% CI 2.37‒70.40; p = 0.003), as well as exposure to anti-CD20 combined with cytotoxic chemotherapy at first-line therapy (HR = 4.70; 95% CI 1.46‒14.96; p = 0.009). Severe infections (grade ≥ 3) showed a higher proportion of microbiologically documented C. infections (50% vs. 28.3%; p < 0.001), viral infections (41.8% vs. 19.9%; p < 0.001), particularly by CMV (4.9% vs. 0%; p = 0.013), bacterial infections (15.8% vs. 6.6%; p = 0.031), and febrile neutropenia (15.7% vs. 2.2%; p < 0.001). The group receiving IRT showed significant differences in treatment patterns, including higher maintenance use of anti-CD20 (50% vs. 13%; p<0.001) and BTK inhibitors (22% vs. 0%; p<0.001), with no differences in the need for hospitalization or mortality. Conclusion: Infections predominantly occurred >12-months after diagnosis, reflecting cumulative immunosuppression and highlighting the need for improved strategies to prevent late infectious morbidity. IRT did not confer a survival advantage in this cohort; however, potential benefits in clinically relevant endpoints ‒ such as reductions in grade ≥3 infections and quality-of-life improvement ‒ remain unassessed and should be prioritized in future studies.
SN - 2531-1379
SN - 2531-1387
ER -