Table 5. Likelihood of infections and... | American Society of Hematology

Table 5.

Likelihood of infections and antimicrobial use associated with infections before vs after IgRT initiation in patients diagnosed with CLL and NHL receiving 1 or more IgRT

	CLL			NHL
	3 mo (n = 196)∗	6 mo (n = 175)∗	12 mo (n = 137)∗	3 mo (n = 417)†	6 mo (n = 343)†	12 mo (n = 250)†
	OR (95% CI)∗∗	OR (95% CI)∗∗	OR (95% CI)∗∗	OR (95% CI)∗∗	OR (95% CI)∗∗	OR (95% CI)∗∗
Infections
All infections,‡,§ n (%)	0.52 (0.38-0.71) ^a,∗	0.66 (0.47-0.92) ^b,∗	0.62 (0.42-0.90) ^g,∗	0.60 (0.49-0.75) ^a,∗	0.70 (0.55-0.90) l^,∗	0.86 (0.63-1.18) ^m
Individual infection, n (%)
Sinopulmonary and skin or soft tissue infections\|\|	0.41 (0.29-0.59) ^a,∗	0.61 (0.44-0.87) ^c,∗	0.68 (0.46-1.00) ^h	0.55 (0.44-0.69) ^a,∗	0.71 (0.56-0.90) ^j,∗	0.95 (0.71-1.28) ⁿ
Pneumonia	0.51 (0.38-0.70)	0.73 (0.54-0.99)	0.82 (0.55-1.20)	0.54 (0.43-0.66)	0.65 (0.52-0.82)	0.75 (0.57-0.99)
Ear-nose-throat infection	0.57 (0.34-0.96)	0.71 (0.44-1.15)	0.56 (0.33-0.98)	0.63 (0.41-0.96)	0.86 (0.57-1.31)	1.06 (0.69-1.63)
Bronchitis	0.44 (0.18-1.09)	0.42 (0.19-0.91)	0.73 (0.35-1.52)	0.77 (0.44-1.33)	0.97 (0.61-1.53)	1.15 (0.72-1.82)
Skin/soft tissue/joint/bone infection	0.55 (0.23-1.33)	0.76 (0.33-1.75)	0.77 (0.36-1.63)	0.71 (0.45-1.13)	0.82 (0.48-1.38)	0.91 (0.55-1.49)
Other infections, n (%)	0.49 (0.34-0.71) ^a,∗	0.55 (0.38-0.79) ^d,∗	0.53 (0.36-0.80) ^i,∗	0.45 (0.36-0.57) ^a,∗	0.52 (0.41-0.67) ^a,∗	0.67 (0.50-0.90) ^o,∗
Severe infections, n (%)
All severe infections,‡,§,¶ n (%)	0.48 (0.35-0.67) ^a,∗	0.52 (0.37-0.74) ^a,∗	0.46 (0.30-0.70) ^a,∗	0.40 (0.32-0.50) ^a,∗	0.42 (0.33-0.54) ^a,∗	0.44 (0.33-0.58)
Individual infection, n (%)
Sinopulmonary and skin or soft tissue infections\|\|	0.38 (0.26-0.57) ^a,∗	0.46 (0.31-0.68) ^a,∗	0.48 (0.29-0.80) ^j,∗	0.38 (0.29-0.49) ^a,∗	0.40 (0.30-0.53) ^a,∗	0.50 (0.36-0.69)
Pneumonia	0.40 (0.27-0.59)	0.50 (0.34-0.74)	0.57 (0.34-0.95)	0.37 (0.28-0.47)	0.37 (0.28-0.50)	0.44 (0.31-0.63)
Ear-nose-throat infection	0.87 (0.35-2.15)	1.13 (0.47-2.72)	0.87 (0.35-2.18)	0.57 (0.28-1.16)	0.62 (0.30-1.28)	0.61 (0.27-1.35)
Bronchitis	0.49 (0.12-2.03)	0.59 (0.14-2.56)	0.66 (0.11-4.09)	0.52 (0.23-1.22)	0.61 (0.30-1.26)	0.74 (0.31-1.75)
Skin/soft tissue/joint/bone infection	0.66 (0.24-1.78)	0.61 (0.21-1.78)	0.56 (0.18-1.77)	0.67 (0.37-1.24)	0.85 (0.42-1.72)	0.66 (0.29-1.51)
Other infections, n (%)	0.33 (0.21-0.52) ^a,∗	0.40 (0.26-0.63) ^a,∗	0.45 (0.28-0.71) ^d,∗	0.28 (0.22-0.37) ^a,∗	0.33 (0.25-0.44) ^a,∗	0.36 (0.26-0.50)
Antimicrobial use associated with infections,# n (%)
Infection episodes requiring antibiotic use	0.38 (0.27-0.54) ^a,∗	0.47 (0.32-0.69) ^a∗	0.52 (0.34-0.79) ^a,∗	0.46 (0.36-0.58) ^a,∗	0.47 (0.37-0.60) ^a,∗	0.61 (0.45-0.82)^d,∗
Infection episodes requiring antiviral use	0.36 (0.25-0.52) ^a,∗	0.40 (0.28-0.58) ^a,∗	0.39 (0.25-0.62) ^a,∗	0.46 (0.37-0.57) ^a,∗	0.53 (0.43-0.67) ^a,∗	0.61 (0.47-0.79) ^a,∗
Infection episodes requiring antifungal use	0.45 (0.30-0.67) ^a,∗	0.57 (0.38-0.86)^e,∗	0.54 (0.32-0.90)^k,∗	0.54 (0.43-0.68) ^a,∗	0.53 (0.42-0.69) ^a,∗	0.56 (0.41-0.76) ^a,∗
Antimicrobial use associated with severe infections,# n (%)
Severe infection episodes requiring antibiotic use	0.42 (0.29-0.60) ^a,∗	0.50 (0.34-0.73)^f,∗	0.46 (0.29-0.73) ^d,∗	0.36 (0.28-0.45) ^a,∗	0.38 (0.29-0.48) ^a,∗	0.42 (0.31-0.56) ^a,∗
Severe infection episodes requiring antiviral use	0.36 (0.24-0.53) ^a,∗	0.37 (0.25-0.55)^a,∗	0.29 (0.17-0.48) ^a,∗	0.37 (0.29-0.47) ^a,∗	0.42 (0.33-0.54) ^a,∗	0.46 (0.34-0.61) ^a,∗
Severe infection episodes requiring antifungal use	0.38 (0.24-0.59) ^a,∗	0.47 (0.30-0.73)^d,∗	0.44 (0.25-0.77)l^,∗	0.48 (0.38-0.61) ^a,∗	0.51 (0.39-0.66) ^a,∗	0.55 (0.40-0.76) ^a,∗

	CLL			NHL
	3 mo (n = 196)∗	6 mo (n = 175)∗	12 mo (n = 137)∗	3 mo (n = 417)†	6 mo (n = 343)†	12 mo (n = 250)†
	OR (95% CI)∗∗	OR (95% CI)∗∗	OR (95% CI)∗∗	OR (95% CI)∗∗	OR (95% CI)∗∗	OR (95% CI)∗∗
Infections
All infections,‡,§ n (%)	0.52 (0.38-0.71) ^a,∗	0.66 (0.47-0.92) ^b,∗	0.62 (0.42-0.90) ^g,∗	0.60 (0.49-0.75) ^a,∗	0.70 (0.55-0.90) l^,∗	0.86 (0.63-1.18) ^m
Individual infection, n (%)
Sinopulmonary and skin or soft tissue infections\|\|	0.41 (0.29-0.59) ^a,∗	0.61 (0.44-0.87) ^c,∗	0.68 (0.46-1.00) ^h	0.55 (0.44-0.69) ^a,∗	0.71 (0.56-0.90) ^j,∗	0.95 (0.71-1.28) ⁿ
Pneumonia	0.51 (0.38-0.70)	0.73 (0.54-0.99)	0.82 (0.55-1.20)	0.54 (0.43-0.66)	0.65 (0.52-0.82)	0.75 (0.57-0.99)
Ear-nose-throat infection	0.57 (0.34-0.96)	0.71 (0.44-1.15)	0.56 (0.33-0.98)	0.63 (0.41-0.96)	0.86 (0.57-1.31)	1.06 (0.69-1.63)
Bronchitis	0.44 (0.18-1.09)	0.42 (0.19-0.91)	0.73 (0.35-1.52)	0.77 (0.44-1.33)	0.97 (0.61-1.53)	1.15 (0.72-1.82)
Skin/soft tissue/joint/bone infection	0.55 (0.23-1.33)	0.76 (0.33-1.75)	0.77 (0.36-1.63)	0.71 (0.45-1.13)	0.82 (0.48-1.38)	0.91 (0.55-1.49)
Other infections, n (%)	0.49 (0.34-0.71) ^a,∗	0.55 (0.38-0.79) ^d,∗	0.53 (0.36-0.80) ^i,∗	0.45 (0.36-0.57) ^a,∗	0.52 (0.41-0.67) ^a,∗	0.67 (0.50-0.90) ^o,∗
Severe infections, n (%)
All severe infections,‡,§,¶ n (%)	0.48 (0.35-0.67) ^a,∗	0.52 (0.37-0.74) ^a,∗	0.46 (0.30-0.70) ^a,∗	0.40 (0.32-0.50) ^a,∗	0.42 (0.33-0.54) ^a,∗	0.44 (0.33-0.58)
Individual infection, n (%)
Sinopulmonary and skin or soft tissue infections\|\|	0.38 (0.26-0.57) ^a,∗	0.46 (0.31-0.68) ^a,∗	0.48 (0.29-0.80) ^j,∗	0.38 (0.29-0.49) ^a,∗	0.40 (0.30-0.53) ^a,∗	0.50 (0.36-0.69)
Pneumonia	0.40 (0.27-0.59)	0.50 (0.34-0.74)	0.57 (0.34-0.95)	0.37 (0.28-0.47)	0.37 (0.28-0.50)	0.44 (0.31-0.63)
Ear-nose-throat infection	0.87 (0.35-2.15)	1.13 (0.47-2.72)	0.87 (0.35-2.18)	0.57 (0.28-1.16)	0.62 (0.30-1.28)	0.61 (0.27-1.35)
Bronchitis	0.49 (0.12-2.03)	0.59 (0.14-2.56)	0.66 (0.11-4.09)	0.52 (0.23-1.22)	0.61 (0.30-1.26)	0.74 (0.31-1.75)
Skin/soft tissue/joint/bone infection	0.66 (0.24-1.78)	0.61 (0.21-1.78)	0.56 (0.18-1.77)	0.67 (0.37-1.24)	0.85 (0.42-1.72)	0.66 (0.29-1.51)
Other infections, n (%)	0.33 (0.21-0.52) ^a,∗	0.40 (0.26-0.63) ^a,∗	0.45 (0.28-0.71) ^d,∗	0.28 (0.22-0.37) ^a,∗	0.33 (0.25-0.44) ^a,∗	0.36 (0.26-0.50)
Antimicrobial use associated with infections,# n (%)
Infection episodes requiring antibiotic use	0.38 (0.27-0.54) ^a,∗	0.47 (0.32-0.69) ^a∗	0.52 (0.34-0.79) ^a,∗	0.46 (0.36-0.58) ^a,∗	0.47 (0.37-0.60) ^a,∗	0.61 (0.45-0.82)^d,∗
Infection episodes requiring antiviral use	0.36 (0.25-0.52) ^a,∗	0.40 (0.28-0.58) ^a,∗	0.39 (0.25-0.62) ^a,∗	0.46 (0.37-0.57) ^a,∗	0.53 (0.43-0.67) ^a,∗	0.61 (0.47-0.79) ^a,∗
Infection episodes requiring antifungal use	0.45 (0.30-0.67) ^a,∗	0.57 (0.38-0.86)^e,∗	0.54 (0.32-0.90)^k,∗	0.54 (0.43-0.68) ^a,∗	0.53 (0.42-0.69) ^a,∗	0.56 (0.41-0.76) ^a,∗
Antimicrobial use associated with severe infections,# n (%)
Severe infection episodes requiring antibiotic use	0.42 (0.29-0.60) ^a,∗	0.50 (0.34-0.73)^f,∗	0.46 (0.29-0.73) ^d,∗	0.36 (0.28-0.45) ^a,∗	0.38 (0.29-0.48) ^a,∗	0.42 (0.31-0.56) ^a,∗
Severe infection episodes requiring antiviral use	0.36 (0.24-0.53) ^a,∗	0.37 (0.25-0.55)^a,∗	0.29 (0.17-0.48) ^a,∗	0.37 (0.29-0.47) ^a,∗	0.42 (0.33-0.54) ^a,∗	0.46 (0.34-0.61) ^a,∗
Severe infection episodes requiring antifungal use	0.38 (0.24-0.59) ^a,∗	0.47 (0.30-0.73)^d,∗	0.44 (0.25-0.77)l^,∗	0.48 (0.38-0.61) ^a,∗	0.51 (0.39-0.66) ^a,∗	0.55 (0.40-0.76) ^a,∗

^aP < .0001; ^bP = .015; ^cP = .006; ^dP = .001; ^eP = .007; ^fP = .000; ^gP = .012; ^hP = .051; ⁱP = .002; ^jP = .005; ^kP = .018; ^lP = .004; ^mP = .345; ⁿP = .750; ^oP = .007.

GEE, generalized estimating equations.

∗

196, 175, and 137 patients had at least 3-month, 6-month, 12-month follow-up time, respectively, before and after IgRT initiation in the CLL cohort.

†

417, 343, and 250 patients had at least 3-month, 6-month, 12-month follow-up time, respectively, before and after IgRT initiation in the NHL cohort.

‡

Medical encounters with the same infection diagnosis within 7 days of each other will be attributed to the same infection episode.

All infections include the individual infection that listed below (ie, pneumonia, pyrexia unknown origin, ear-nose-throat infections, bronchitis, skin/soft tissue/joint/bone infections, sepsis, bacteremia, genitourinary infections, gastrointestinal infections, brain/spinal infections, COVID-19, blood infections other than sepsis, cardiac infections, and other [not otherwise specified]).

Sinopulmonary and skin or soft tissue infections include pneumonia, ear-nose-throat infections, bronchitis, and skin/soft tissue/joint/bone infections.

A severe infection was defined as an infection leading to a hospitalization or a treatment with any intravenous antibiotic, antiviral, or antifungal medication.

Patients with infections requiring antimicrobials was defined as medical encounters with a diagnosis of infection and a prescription of antibiotics/antiviral/antifungal for the same diagnosis within 30 days.

∗∗

GEE logistic regression model with robust variance was fit to obtain OR, 95% CI, and P value for comparing infection rate in the post-IgRT period to that in the pre-IgRT period. P < .05 were considered to be significant and denoted with “∗.”

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