CLINICAL, LABORATORY AND X-RAY PECULIARITIES OF INVASIVE ASPERGILLOSIS IN B-CELLULAR LYMPHOMS PATIENTS

• Main Authors: Y. A. CHUDINOVSKIKH, T. Y. SEMIGLAZOVA, N. N. KLIMKO, A. A. BARCHUK, O. V. SHADRIVOVA, E. V. FROLOVA, T. S. BOGOMOLOVA, S. M. IGNATIEVA, S. M. ALEXEEV, I. S. ZYUZGIN, L. V. FILATOVA, V. V. SEMIGLAZOV, E. V. KHARCHENKO, A. B. KOSICHKINA, M. S. MOTALKINA, U. B. KHADONOV, Y. A. OLEYNIK, A. A. ZVERKOVA, I. V. OSHMATOVA, A. Y. SUBORA, S. A. SHALAEV, P. S. SHILO
• Format: Article
• Language: Russian
• Published: Remedium Group LLC 2017-06-01
• Series: Медицинский совет
• Subjects: invasive aspergillosis; b-cell lymphoma; aspergillus spp
• Online Access: https://www.med-sovet.pro/jour/article/view/1899

The study included 108 patients with B-cell lymphoma which had complication with invasive aspergillosis, 57 patients with Hodgkin lymphoma (HL) and 51 patients with non-Hodgkin lymphoma (NHL). All patients in both groups received chemotherapy before the development of invasive aspergillosis, 73% of patients with HL and 67% patients with NHL received chemotherapy for induction and consolidation of remission. The main predictive factors for IA in patients with HL and NHL were: prolonged lymphocytopenia (70% vs 48%), agranulocytosis (64% vs 71%), use of glucocorticosteroids as part of treatment protocol (61% vs 85%), presence of B – symptoms (63% vs 48%), respectively. In most cases nosocomial invasive aspergillosis was diagnosed in both groups: 65% vs 83% respectively. We identified etiological agents in Hodgkin and non-Hodgkin lymphoma patients: A. fumigatus (50% vs 39%), A. niger (43% vs 33%) and A. flavus (7% vs 8%). The lungs were involved in 100% cases, in group with NHL patients 6% had combined lesions in lungs and other organs and different types of tissues. Clinical manifestation of IA was nonspecific in both groups: fever – 83% vs 76%, cough – 75% vs 59%, respiratory insufficiency – 50% vs 40%, respectively. CT-signs of IA were also nonspecific in both groups: infiltrative (75% vs 66%), focal changes (61% vs 63%), and «ground-glass opacity» (28% vs 31%), respectively. In most cases patients were treated with voriconazole in both patients (88% vs 98%). Overall 12-weeks survival in patients with Hodgkin lymphoma and invasive aspergillosis was 84%, in patients with non-Hodgkin lymphoma and invasive aspergillosis – 81%.