Back to Search
Start Over
Antimicrobial use before chronic lymphocytic leukemia: a retrospective cohort study
- Source :
- Leukemia. 35:747-751
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Chronic lymphocytic leukemia (CLL) is accompanied by increased risk of potentially fatal infections. While this can mostly be attributed to disease-related immune dysfunction, it is not known if CLL patients are also constitutionally susceptible to infections. We linked nation-wide Danish registers to explore this possibility, approximating infection susceptibility by use of antimicrobials. We assessed the incidence of antimicrobials among CLL patients and matched controls from the general population for up to 22 years before index diagnosis, and among children and grandchildren of CLL patients and their matched controls. Our analyses showed that for CLL patients overall antimicrobial use began to increase gradually six years before leukemia diagnosis. Before this time point, CLL patients had used significantly more macrolides (relative risk = 1.15; 95% confidence interval 1.10-1.20), antimycotics (1.18; 1.08-1.30), and antivirals (1.62; 1.45-1.81) than controls for up to 22 years before diagnosis. The same pattern of increased use was found among CLL patients' children and grandchildren. Our study suggests that CLL diagnosis is preceded by decades of increased susceptibility to infections. The duration of this time window is compatible with causal roles of immune dysfunction and/or certain infections in CLL pathogenesis, possibly mediating the association between constitutional infection susceptibility and CLL risk.
- Subjects :
- Adult
Male
0301 basic medicine
Cancer Research
medicine.medical_specialty
Denmark
Chronic lymphocytic leukemia
Population
Pathogenesis
03 medical and health sciences
0302 clinical medicine
immune system diseases
hemic and lymphatic diseases
Internal medicine
medicine
Humans
Child
education
Retrospective Studies
Aged, 80 and over
education.field_of_study
Bacteria
business.industry
Incidence (epidemiology)
Retrospective cohort study
Bacterial Infections
Hematology
Prognosis
medicine.disease
Leukemia, Lymphocytic, Chronic, B-Cell
Confidence interval
Anti-Bacterial Agents
Leukemia
030104 developmental biology
Oncology
Case-Control Studies
030220 oncology & carcinogenesis
Relative risk
Female
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 14765551 and 08876924
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Leukemia
- Accession number :
- edsair.doi.dedup.....2459552532e3304fac8dd8957b2fe0ff