Incidence of infectious complications with the combination of bendamustine and an anti-CD20 monoclonal antibody^*

Abstract

Combination of bendamustine (B) and rituximab (R) has been associated with opportunistic infections (OI) in case reports. This retrospective analysis evaluated the incidence, risk factors, and types of infectious complications (IC) in adults with CD20+ non-Hodgkin lymphoma who received ≥2 cycles of B and either R or ofatumumab. Infection data were collected up to 1-year post-B-based treatment. Potential risk factors for IC were assessed using univariate analysis with Fisher's exact test. Four-hundred and sixteen patients were included. Incidence of IC and OI was 20 and 6%, respectively. Viral (n = 19), fungal (n = 1), and Pneumocystis jiroveci pneumonia (n = 5) infections occurred. OI was associated with lack of antimicrobial prophylaxis analysis (p = .048). The incidences of IC and OI with B and anti-CD20 antibody combination at our institution appear lower than those previously reported, possibly due to antimicrobial prophylaxis and G-CSF use.

Keywords:

• Lymphoma and Hodgkin disease
• bendamustine
• rituximab
• infectious complications
• opportunistic

Acknowledgements

The authors thank Thu Oanh Dang: Department of Pharmacy, Massachusetts General Hospital, Boston, MA; John F Gerecitano: Janssen Pharmaceuticals, Johnson and Johnson, Raritan, NJ; Paul A Hamlin Jr.: Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY; Tobias M Hohl: Department of Medicine, Infectious Disease Service, Memorial Sloan Kettering Cancer Center, New York, NY; Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY; Anita Kumar: Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY; Alison J. Moskowitz: Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY; Craig H Moskowitz: Oncology Service, Department of Medicine, Sylvester Comprehensive Cancer, Miami, FL; Department of Medicine, Miller School of Medicine, Miami, FL; Ariela Noy: Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY; Lia Palomba: Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY; Carol S Portlock: Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY; Matthew J. Matasar: Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY; Anas Younes: Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY; Andrew D. Zelenetz: Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY.

Disclosure statement

No potential conflict of interest was reported by the authors.