TY - JOUR
T1 - The association between infections and chemotherapy interruptions among cancer patients
T2 - Prospective cohort study
AU - Taha, Ahmed
AU - Vinograd, Inbal
AU - Sakhnini, Ali
AU - Eliakim-Raz, Noa
AU - Farbman, Laura
AU - Baslo, Rina
AU - Stemmer, Salomon M.
AU - Gafter-Gvili, Anat
AU - Leibovici, Leonard
AU - Paul, Mical
N1 - Publisher Copyright:
© 2014 The British Infection Association.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Objectives: Adherence to scheduled chemotherapy is important for optimal outcomes of cancer patients. We examined causes for delay or cancellation of planned chemotherapy, focusing on mild respiratory infections during the winter. Methods: Prospective cohort study. We included all adults with solid or hematologic cancer receiving active chemotherapy treatment during the winter of 2010-2011 in a cancer center. We compared baseline characteristics and outcomes between patients with and without chemotherapy delays, cancellations, or dose-reductions ("chemotherapy delay"). Results: We included 547 patients receiving chemotherapy during the winter of 2011. Of these, 213 (38.9%) patients experienced 306 episodes of chemotherapy delays. The main documented reasons for the chemotherapy delay were neutropenia (84/306, 27.4%), fever or infection (73/306, 23.9%) and thrombocytopenia (26/306, 8.5%). Independent risk factors for chemotherapy delays were upper respiratory infections (OR 1.87, 95% CI 1.27-2.76), lymphopenia, prior hospitalization, peripheral vascular disease and colon cancer relative to hematologic cancer. In the adjusted analysis focusing on chemotherapy delays due to infection alone, upper respiratory infections (OR 5.25, 95% I 2.81-9.84) and age were significant independent risk factors. Discussion: Mild respiratory infections were associated with chemotherapy delays. Our results should encourage modalities to prevent influenza and other upper respiratory infections among cancer patients.
AB - Objectives: Adherence to scheduled chemotherapy is important for optimal outcomes of cancer patients. We examined causes for delay or cancellation of planned chemotherapy, focusing on mild respiratory infections during the winter. Methods: Prospective cohort study. We included all adults with solid or hematologic cancer receiving active chemotherapy treatment during the winter of 2010-2011 in a cancer center. We compared baseline characteristics and outcomes between patients with and without chemotherapy delays, cancellations, or dose-reductions ("chemotherapy delay"). Results: We included 547 patients receiving chemotherapy during the winter of 2011. Of these, 213 (38.9%) patients experienced 306 episodes of chemotherapy delays. The main documented reasons for the chemotherapy delay were neutropenia (84/306, 27.4%), fever or infection (73/306, 23.9%) and thrombocytopenia (26/306, 8.5%). Independent risk factors for chemotherapy delays were upper respiratory infections (OR 1.87, 95% CI 1.27-2.76), lymphopenia, prior hospitalization, peripheral vascular disease and colon cancer relative to hematologic cancer. In the adjusted analysis focusing on chemotherapy delays due to infection alone, upper respiratory infections (OR 5.25, 95% I 2.81-9.84) and age were significant independent risk factors. Discussion: Mild respiratory infections were associated with chemotherapy delays. Our results should encourage modalities to prevent influenza and other upper respiratory infections among cancer patients.
KW - Chemotherapy
KW - Influenza
KW - Malignancy
KW - Medication adherence
KW - Neutropenia
KW - Respiratory tract infections
UR - http://www.scopus.com/inward/record.url?scp=84922822118&partnerID=8YFLogxK
U2 - 10.1016/j.jinf.2014.10.008
DO - 10.1016/j.jinf.2014.10.008
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C2 - 25444974
AN - SCOPUS:84922822118
SN - 0163-4453
VL - 70
SP - 223
EP - 229
JO - Journal of Infection
JF - Journal of Infection
IS - 3
ER -