Infectious complications during protocol-based therapy for chronic lymphocytic leukaemia
https://doi.org/10.36604/1998-5029-2025-96-104-113
Abstract
Aim. To investigate the frequency and features of infectious complications in patients with chronic lymphocytic leukaemia (CLL) treated at the Order of the Badge of Honour Irkutsk Regional Clinical Hospital (Irkutsk, Russian Federation) from 2012 to 2023.
Materials and methods. We reviewed 490 medical records and outpatient charts of patients with CLL followed by haematologists at the hospital during 2012–2023. Four hundred patients received protocol-based chemotherapy (PBC); 202 of them were diagnosed with various infectious complications. These 202 patients were divided into three groups: group 1 – 71 patients who received PBC in 2012–2015; group 2 – 64 patients treated in 2016–2019; group 3 – 67 patients treated in 2020–2023.
Results and discussion. The most common infectious complications were bacterial pneumonia (31.7 %), infections of the upper respiratory tract, trachea and bronchi (28 %), urinary-tract infections (11.6 %) and coronavirus disease 2019 (COVID-19)-associated pneumonias in 2020–2023 (20.7 %). The highest number of infectious events occurred in relapsing patients at the terminal stage of the disease. From 2020 to 2023 the incidence of bacterial pneumonias and infections of the upper respiratory tract, trachea and bronchi decreased, which is attributed to the introduction of targeted drugs that can be administered in day-hospital or outpatient settings.
Conclusion. The findings provide new information that can be used to prevent infectious complications during protocol-based therapy for CLL and to develop effective prophylactic measures.
Supporting agencies: This study was not sponsored
About the Authors
N. R. Solovkova
State Budgetary Healthcare Institution Irkutsk Regional Clinical Hospital, winner of the “Mark of the Honor” award
Russian Federation
Russian Federation
Natalya R. Solovkova, MD, Haematologist
Day-Hospital Haematology and Chemotherapy Unit
664049; 100 Yubileyny Dst.; Irkutsk
N. O. Saraeva
State Budgetary Healthcare Institution Irkutsk Regional Clinical Hospital, winner of the “Mark of the Honor” award
Russian Federation
Russian Federation
Natalya O. Saraeva, MD, DSc (Med.), Deputy Chief Physician for Internal Medicine
664049; 100 Yubileyny Dst.; Irkutsk
V. V. Voitsekhovsky
Federal State Budgetary Educational Institution of Higher Education «Amur State Medical Academy» of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Valeriy V. Voytsekhovskiy, MD, DSc (Med.), Professor, Head of Department
Department of Hospital Therapy with Pharmacology Course
675000; 95 Gor'kogo Str.; Blagoveshchensk
References
1. Piskunova I.S., Moiseeva T.N., Al-Radi L.S., Kokhno A.V., Zvonkov E.E. [Diagnostics and treatment of chronic lymphocytic leukemia/small lymphocyte lymphoma. In: Parovichnikova E.N., editor. Diagnostic algorithms and treatment protocols for blood diseases]. Moscow: NMITSG, ID «PraktikA»; 2024:203–247 (in Russian).
2. Morton L.M., Wang S.S., Devesa S.S., Hartge P., Weissenburger D.D., Linet M.S. Lymphoma incidence patterns by WHO subtype in the United States, 1992-2001. Blood 2006; 107(1):265–276. doi: 10.1182/blood-2005-06-2508
3. Watson L., Wyld P., Catovsky D. Disease burden of chronic lymphocytic leukaemia within the European Union. Eur. J. Haematol. 2008; 81(4):253–258. doi: 10.1111/j.1600-0609.2008.01114.x
4. Jemal A., Siegel R., Ward E., Murray T., Xu J., Tung M.J. Cancer statistics, 2007. Cancer J. Clin. 2007; 57(1):43–66. doi: 10.3322/canjclin.57.1.43
5. Kaprin A.D., Starinsky V.V., Petrova G.V., editors. [Malignant neoplasms in Russia in 2017 (incidence and mortality)]. Moscow: MNIOI im. P.A. Gertsena – filial FGBU «NMITS radiologii» Minzdrava Rossii; 2018 (in Russian).
6. Vorob'yev A.I., editor. [Handbook of hematology (Vol. 2)]. Moscow, 2003: 40–184 (in Russian).
7. [Chronic lymphocytic leukemia/small lymphocyte lymphoma. Clinical guidelines]. Moscow; 2022 (in Russian). Available at: https://oncology-association.ru/wp-content/uploads/2022/06/hronicheskij-limfoczitarnyj-lejkoz1.pdf?ys-clid
8. Binnet J.L., Auqer A., Dighiero G.H., Chastang S., Piguet N. Goasguen J., Vaugier G., Potron G., Colona P., Oberling F., Thomas M.J., Tchernia G., Jacquillat C., Boivin P., Lesty C., Duault M.T., Monconduit M., Belabbes S., Gremy F. A new prognostic classification of chronic lymphocytic leukemia derived from multivariant survival analysis. Cancer 1981; 48(1):198–206. doi: 10.1002/1097-0142(19810701)48:1<198::aid-CNCR2820480131>3.0.co; 2-v
9. International CLL-IPI working group. An international prognostic index for patients with chronic lymphocytic leukaemia (CLL-IPI): a meta-analysis of individual patient data. Lancet Oncol. 2016; 17(6):779–790. doi: 10.1016/S1470-2045(16)30029-8
10. Semochkin S.V., Arshanskaya E.G., Zakharov O.D., Kotel'nikova A.N., Kulikova S.S., Ovanesova E.V., Kochkareva Yu.B., Ivanova V.L. [Combination of bendamustine and rituximab in the treatment of relapsed and refractory chronic lymphocytic leukemia: results of a retrospective study]. Oncohematology 2015; 1:16–23 (in Russian).
11. Nikitin E.A., Ptushkin V.V., editors. [Chronic lymphocytic leukemia. Modern diagnostics and treatment]. Moscow: GEOTAR-Media; 2023 (in Russian). ISBN: 978-5-9704-7597-3.
12. Eichhorst B., Robak T., Montserrat E., Ghia P., Niemann C.U., Kater A.P., Gregor M., Cymbalista F., Buske C., Hillmen P., Hallek M., Mey U. Chronic lymphocytic leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 2021; 32(1): 23–33. doi: 10.1016/j.annonc.2020.09.019
13. Nikitin E.A. [Ibrutinib in the treatment of chronic lymphocytic leukemia]. Clinical oncohematology 2017; 10(3):282–286 (in Russian).
14. Voytsekhovskiy V.V., Zabolotskikh T.V., Grigorenko A.A., Filatova E.A. [Bronchopulmonary complications of chronic leukemia]. Blagoveshchensk: DalGAU, 2019 (in Russian).
15. Voytsekhovskiy V.V., Esenina T.V., Mishkurova K.M., Filatova E.A., Fedorova N.A., Sinyuk A.A., Sayapina M.V., Kasumova D.M., Rusalovskaya I.Yu., Ragbarova A.R. [Therapy of patients with chronic lymphocytic leukemia during the COVID-19 pandemic]. Bûlleten' fiziologii i patologii dyhaniâ = Bulletin of Physiology and Pathology of Respiration 2024; 92:107–116 (in Russian). doi: 10.36604/1998-5029-2024-92-107-116
16. Oken M.M., Creech R.H., Tormey D.C., Horton J., Davis T.E., McFadden E.T., Carbone P.P. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am. J. Clin. Oncol. 1982; 5(6):649–655.
17. Linn B.S., Linn M.W., Gurel L. Cumulative illness rating scale. J. Am. Geriatr. Soc. 1968; 16(5):622–626. doi: 10.1111/j.1532-5415.1968.tb02103.x
18. Gel'fand B.R., editor. [Nosocomial pneumonia in adults: Russian national recommendations]. Moscow: OOO «Izdatel'stvo «Meditsinskoye informatsionnoye agentstvo»; 2016 (in Russian). ISBN: 978-5-9986-0284-9.
19. Savchenko V.G., editor. [Diagnostic algorithms and treatment protocols for blood diseases (Vol. 2)]. Moscow: NMITS Gematologii; 2018 (in Russian).
Review
For citations:
Solovkova N.R., Saraeva N.O., Voitsekhovsky V.V. Infectious complications during protocol-based therapy for chronic lymphocytic leukaemia. Bulletin Physiology and Pathology of Respiration. 2025;(96):104-113. (In Russ.) https://doi.org/10.36604/1998-5029-2025-96-104-113
Views:
54
Email this article 