Low mannose-binding lectin concentration is associated with severe infection in patients with hematological cancer who are undergoing chemotherapy


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Low mannose-binding lectin concentration is associated with severe infection in patients with hematological cancer who are undergoing chemotherapy
Clinical Infectious Diseases
Vekemans  M., Robinson  J., Georgala  A., Heymans  C., Muanza  F., Paesmans  M., Klastersky  J., Barette  M., Meuleman  N., Huet  F., Calandra  T., Costantini  S., Ferrant  A., Mathissen  F., Axelsen  M., Marchetti  O., Aoun  M.
1537-6591 (Electronic)
Statut éditorial
Date de publication
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Jun 15
BACKGROUND: Mannose-binding lectin (MBL) is a serum lectin involved in innate immune response. Low serum MBL concentration may constitute a risk factor for infection in patients receiving myelosuppressive chemotherapy. METHODS: We conducted a prospective, observational study that assessed MBL concentration as a risk factor for infection in patients with hematological malignancy who were hospitalized to undergo at least 1 chemotherapy cycle. MBL deficiency was defined using an algorithm that considered the serum MBL concentration and the MBL genotype. The primary end point was the ratio of duration of febrile neutropenia to the duration of neutropenia. Secondary end points included the incidence of severe infection (e.g., sepsis, pneumonia, bacteremia, and invasive fungal infection). Logistic regression analysis was conducted, and Fisher's exact test was used to analyze binary outcomes, and Kaplan-Meier estimates and log rank tests were used for time-to-event variables. RESULTS: We analyzed 255 patients who received 569 cycles of chemotherapy. The median duration of neutropenia per cycle was 7 days (interquartile range, 0-13 days). Sixty-two patients (24%) were found to have MBL deficiency. Febrile neutropenia occurred at least once in 200 patients. No difference in the primary outcome was seen. The incidence of severe infection was higher among MBL-deficient patients than among non-MBL-deficient patients (1.96 vs. 1.34 cases per 100 days for analysis of all patients [P=.008] and 1.85 vs. 0.94 cases per 100 days excluding patients with acute leukemia [P<.001]). CONCLUSIONS: MBL deficiency does not predispose adults with hematological cancer to more-frequent or more-prolonged febrile episodes during myelosuppressive chemotherapy, but MBL-deficient patients have a greater number of severe infections and experience their first severe infection earlier, compared with nondeficient patients.
Adult Aged Antineoplastic Agents/*adverse effects Disease Susceptibility/*blood/immunology Female Hematologic Neoplasms/complications/drug therapy Humans Kaplan-Meiers Estimate Male Mannose-Binding Lectin/*blood/*deficiency Middle Aged Neutropenia/chemically induced Pneumonia/*blood/immunology Prospective Studies Risk Factors Sepsis/*blood/immunology
Web of science
Open Access
Création de la notice
25/01/2008 14:33
Dernière modification de la notice
14/02/2022 8:53
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