Bacterial and viral pneumonias in patients with chronic lymphocytic leukemia
https://doi.org/10.36604/1998-5029-2026-100-22-36
Abstract
Introduction. Patients with chronic lymphocytic leukemia (CLL) are at high risk of infectious complications due to secondary immunodeficiency. Aim. To study the dynamics of incidence and characterize the clinical features of bacterial and viral pneumonias in CLL patients undergoing programmed therapy.
Materials and methods. A retrospective analysis of medical records from 452 CLL patients treated at the State Budgetary Healthcare Institution "Irkutsk Regional Clinical Hospital" (Irkutsk) between 2012 and 2023 was performed.
Results. Bronchopulmonary infections predominated among intercurrent infections: bacterial pneumonias accounted for 31.7% and viral pneumonias for 20.7% of all infectious episodes. Bacterial pneumonia most frequently developed at advanced stages of tumor progression. A statistically significant decrease in the incidence of bacterial pneumonias was observed in the 2020–2023 patient cohort compared to earlier periods (p < 0.05). A high proportion of atypical pneumonia forms was identified: in 21% of cases, the course was oligosymptomatic with minimal physical findings and prominent extrapulmonary manifestations; in 28%, the pneumonia followed a masked course, with symptoms obscured by the clinical picture of the underlying disease. During 2020–2023, SARS-CoV-2–associated pneumonia ranked second among complications. Viral pneumonias were milder in patients receiving Bruton’s tyrosine kinase inhibitors (BTKi) compared to those treated with immunochemotherapy.
Conclusion. In diagnosing bacterial pneumonias in CLL patients, the possibility of atypical presentation during the early stages of the inflammatory process must be considered. In our opinion, the reduced frequency of bacterial pneumonias and the more favorable course of viral pneumonias are attributable to the introduction of BTKi into clinical practice, as well as preventive measures (pneumococcal vaccination and replacement therapy with intravenous immunoglobulins).
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
100 Yubileyny Dst., Irkutsk, 664049
N. O. Saraeva
Federal State Budgetary Educational Institution of Higher Education "Irkutsk State Medical University" of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Natalya O. Saraeva, MD, DSc (Med.), Professor of Department of Hospital Therapy
1 Krasnogo Vosstaniya Str., Irkutsk, 664003
V. V. Voytsekhovskiy
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 of Hospital Therapy with Pharmacology Course named after Professor Yu.S. Landyshev
95 Gor'kogo Str., Blagoveshchensk, 675000
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For citations:
Solovkova N.R., Saraeva N.O., Voytsekhovskiy V.V. Bacterial and viral pneumonias in patients with chronic lymphocytic leukemia. Bulletin Physiology and Pathology of Respiration. 2026;(100):22-36. (In Russ.) https://doi.org/10.36604/1998-5029-2026-100-22-36
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