title: Risk factors for febrile neutropenia during chemotherapy for HIV-related lymphoma.
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/µL with body temperature over 38℃; 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.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jinyong
authors.initials: J
authors.lastname: Park
authors.forename: Tae Min
authors.initials: TM
authors.lastname: Kim
authors.forename: Jeong-Hwan
authors.initials: JH
authors.lastname: Hwang
authors.forename: Nak-Hyun
authors.initials: NH
authors.lastname: Kim
authors.forename: Pyoeng Gyun
authors.initials: PG
authors.lastname: Choe
authors.forename: Kyoung-ho
authors.initials: KH
authors.lastname: Song
authors.forename: Eu Suk
authors.initials: ES
authors.lastname: Kim
authors.forename: Sang-Won
authors.initials: SW
authors.lastname: Park
authors.forename: Hong Bin
authors.initials: HB
authors.lastname: Kim
authors.forename: Nam Joong
authors.initials: NJ
authors.lastname: Kim
authors.forename: Wan Beom
authors.initials: WB
authors.lastname: Park
authors.forename: Myoung-don
authors.initials: MD
authors.lastname: Oh
mesh_terms: D000328:Adult; D000367:Age Factors; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D001831:Body Temperature; D018791:CD4 Lymphocyte Count; D005334:Fever / Q000209:etiology*; D015658:HIV Infections / Q000150:complications; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009503:Neutropenia / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014750:Vincristine / Q000627:therapeutic use*
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine