INFECTIOUS COMPLICATIONS AFTER 2-CHLORODEOXYADENOSINE THERAPY

Infection is a common adverse event after therapy with nucleoside anal ogs, including 2-chlorodeoxyadenosine (CdA). However, the incidence of CdA-related infections has been poorly documented. In this study we c ompare, in the same patient population, the incidence of infectious ep isodes during the 6-month period before CdA to their incidence during the 6 months after initiating therapy. Ninety-five patients with hemat ological malignancies were studied. The incidence of infectious episod es almost doubled after CdA (0.87 vs. 0.47 during the pre-CdA period). The following factors were associated with an increased risk of infec tion after therapy: a history of previous chemotherapy, infection duri ng the pre-CdA period and a diagnosis of chronic lymphocytic leukemia or of non-Hodgkin's lymphoma. Age, neutrophil and lymphocyte count at onset of CdA and time interval between diagnosis and therapy with CdA did not correlate with;the infectious risk. The pattern of infections was modified after therapy with an increase of herpes virus infections (1 vs. 8 episodes, p=0.04) and of fever of unknown origin (6 vs. 17 e pisodes, p=0.03). In conclusion, a population at high risk for develop ing infectious complications after CdA therapy can be identified. Spec ific measures aimed at reducing the incidence of infectious events sho uld concentrate on this population.