0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Listeriosis in Patients with Chronic Lymphocytic Leukemia Who Were Treated with Fludarabine and Prednisone

Elias Anaissie, MD; Dimitrios P. Kontoyiannis, MD; Hagop Kantarjian, MD; Linda Elting, PhD; Lester E. Robertson, MD; and Michael Keating, MD
[+] Article and Author Information

Grant Support: In part by the Infectious Disease Research Fund, Section of Infectious Disease, The University of Texas M. D. Anderson Cancer Center.

Requests for Reprints: Elias J. Anaissie, MD, Section of Infectious Diseases, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 47, Houston, TX 77030.

Current Author Addresses: Drs. Anaissie, Kontoyiannis, Kantarjian, Elting, Robertson, and Keating: The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 47, Houston, TX 77030.


Ann Intern Med. 1992;117(6):466-469. doi:10.7326/0003-4819-117-6-466
Text Size: A A A

Objective: To determine whether therapy with fludarabine plus prednisone in patients with chronic lymphocytic leukemia increases the risk for developing listeriosis.

Design: Retrospective cohort study based on hospital surveillance data.

Setting: Referral cancer center.

Participants: A total of 795 patients with chronic lymphocytic leukemia who received care at The University of Texas M. D. Anderson Cancer Center between 1980 and 1990.

Interventions: Patients were treated with fludarabine alone or fludarabine and prednisone.

Measurements: The listeriosis attack rate was analyzed according to the type of treatment received.

Results: Seven of 408 patients in the fludarabine group developed listeriosis (1. 7%; 95% Cl, 0.2% to 6%) compared with 0 of 387 patients who received conventional chemotherapy alone (0% to 0.9%; P = 0.015). The 7 patients were among 248 patients who were treated with both fludarabine and prednisone; none of 160 patients treated with fludarabine alone developed listeriosis (P = 0.045 by the Fisher exact test). A dramatic reduction in CD4 counts occurred in patients after fludarabine and prednisone treatment and coincided with the development of listeriosis.

Conclusion: The administration of fludarabine plus prednisone is associated with an increased incidence of listeriosis in patients with chronic lymphocytic leukemia. The depletion of CD4 cells may underlie the pathogenesis.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Journal Club
Related Point of Care
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)