[논문]Severe Pulmonary Adverse Effects in Lymphoma Patients Treated with Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (CHOP) Regimen Plus Rituximab

Lim, Kyu-Hyoung; Yoon, Ho-Il; Kang, Young Ae; Lee, Keun-Wook; Kim, Jee Hyun; Bang, Soo-Mee; Lee, Jae Ho; Lee, Choon-Taek; Lee, Jong Seok

doi:10.3904/kjim.2010.25.1.86

Severe Pulmonary Adverse Effects in Lymphoma Patients Treated with Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (CHOP) Regimen Plus Rituximab 원문보기

The Korean journal of internal medicine : KJIM, v.25 no.1, 2010년, pp.86 - 92

Lim, Kyu-Hyoung (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.) , Yoon, Ho-Il (Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.) , Kang, Young Ae (Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.) , Lee, Keun-Wook (Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.) , Kim, Jee Hyun (Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.) , Bang, Soo-Mee (Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.) , Lee, Jae Ho (Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.) , Lee, Choon-Taek (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.) , Lee, Jong Seok (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.)

Abstract ▼ AI-Helper

Background/AimsThe aim of our study was to determine the incidence and clinical features of severe pulmonary complications in patients receiving cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or rituximab plus CHOP (R-CHOP) as the initial treatment for lymphoma.MethodsA retrospective analysis of pulmonary infection and drug-induced interstitial pneumonitis (DIIP) was performed using lymphoma registry data. R-CHOP was administered in 71 patients and CHOP in 29 patients.ResultsThe severe pulmonary adverse events tended to occur more frequently with R-CHOP (18.3%) than CHOP alone (13.8%), although the difference was not significant (p = 0.771). DIIP occurred in five patients in the R-CHOP arm (7%) and in one in the CHOP arm (3%). The continuous use of steroids for conditions other than lymphoma significantly increased the risk of pulmonary infection including Pneumocystis jiroveci pneumonia (p = 0.036) in the multivariate analysis. International prognostic index, tumor stage, smoking, previous tuberculosis, chronic obstructive pulmonary disease, and lymphoma involvement of lung parenchyma were not related to pulmonary adverse events. Patients who experienced severe pulmonary events showed shorter survival when compared to those without complications (p = 0.002).ConclusionsOur experiences with serial cases with DIIP during chemotherapy and the correlation of continuous steroid use with pulmonary infection suggest that the incidence of pulmonary complications might be high during lymphoma treatment, and careful monitoring should be performed.

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참고문헌 (19)

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Severe Pulmonary Adverse Effects in Lymphoma Patients Treated with Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (CHOP) Regimen Plus Rituximab 원문보기

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