Skip to main content
Top
Published in: Infection 4/2022

Open Access 19-02-2022 | COVID-19 | Original Paper

Impact of the first COVID-19 lockdown in Germany on the rate of acute infections during intensive chemotherapy for Hodgkin lymphoma

Authors: Anne Sophie Jacob, Helen Kaul, Michael Fuchs, Sarah Gillessen, Stefanie Kreissl, Annette Pluetschow, Jesko Momotow, Valdete Schaub, Andreas Huettmann, Mathias Haenel, Andreas Zimmermann, Judith Dierlamm, Julia Meissner, Stephan Mathas, Sonja Martin, Andreas Engert, Michael Hallek, Peter Borchmann, Clara Lehmann

Published in: Infection | Issue 4/2022

Login to get access

Abstract

Purpose

Evidence on the effect of self-protection via social distancing and wearing face-masks on infections during chemotherapy is currently not available. We asked if the occurrence of acute infections during chemotherapy for advanced-stage Hodgkin lymphoma (HL) decreased when COVID-19 protection measures were in effect.

Methods

We analyzed the occurrence of infections during all documented eBEACOPP cycles starting between 01 March and 30 June of 2017 to 2020 in patients treated within the GHSG HD21 study in Germany and compared the infection rates and characteristics by logistic regression models and means of descriptive statistics.

Results

We analyzed 911 cycles of 313 adult patients treated with 4 to 6 cycles of eBEACOPP. We found a significant decrease in the occurrence of infections during chemotherapy for HL during COVID-19 lockdown from 131 (19.6%) of 670 cycles in 2017–2019 to 30 (12.6%) of 239 cycles during COVID-19 lockdown [OR 0.574 (95% CI 0.354–0.930), P = 0.024]. The strongest effect was evident for unspecified infections with 39 cycles (5.8%) during 2017–2019 in comparison to 5 cycles (2.1%) during COVID-19 lockdown. 20 (24.1%) of 83 patients had an infection during the COVID-19 lockdown versus 99 (43.2%) of 229 patients in the years 2017–2019 (P = 0.0023).

Conclusion

The significant decrease of infections during chemotherapy for HL during COVID-19 lockdown reveals the protective measures’ potential to shield patients from transmissible pathogens. We conclude that these measures could be recommended for HL patients at risk for infections during chemotherapy.
Appendix
Available only for authorised users
Literature
1.
go back to reference Diehl V, Franklin J, Pfreundschuh M, et al. Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin’s disease. N Engl J Med. 2003;348:2386–95.CrossRef Diehl V, Franklin J, Pfreundschuh M, et al. Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin’s disease. N Engl J Med. 2003;348:2386–95.CrossRef
2.
go back to reference Evens AM, Hutchings M, Diehl V. Treatment of Hodgkin lymphoma: the past, present, and future. Nat Clin Pract Oncol. 2008;5:543–56.CrossRef Evens AM, Hutchings M, Diehl V. Treatment of Hodgkin lymphoma: the past, present, and future. Nat Clin Pract Oncol. 2008;5:543–56.CrossRef
3.
go back to reference Gafter-Gvili A, Fraser A, Paul M, et al. Antibiotic prophylaxis for bacterial infections in afebrile neutropenic patients following chemotherapy. Cochrane Database Syst Rev. 2012;1:CD004386.PubMed Gafter-Gvili A, Fraser A, Paul M, et al. Antibiotic prophylaxis for bacterial infections in afebrile neutropenic patients following chemotherapy. Cochrane Database Syst Rev. 2012;1:CD004386.PubMed
4.
go back to reference Engert A, Goergen H, Markova J, et al. Reduced-intensity chemotherapy in patients with advanced-stage Hodgkin lymphoma: updated results of the open-label, international, randomised phase 3 HD15 trial by the German Hodgkin study group. Hemasphere. 2017;1:e5.CrossRef Engert A, Goergen H, Markova J, et al. Reduced-intensity chemotherapy in patients with advanced-stage Hodgkin lymphoma: updated results of the open-label, international, randomised phase 3 HD15 trial by the German Hodgkin study group. Hemasphere. 2017;1:e5.CrossRef
5.
go back to reference Taplitz RA, Kennedy EB, Bow EJ, et al. Antimicrobial prophylaxis for adult patients with cancer-related immunosuppression: ASCO and IDSA clinical practice guideline update. J Clin Oncol. 2018;36:3043–54.CrossRef Taplitz RA, Kennedy EB, Bow EJ, et al. Antimicrobial prophylaxis for adult patients with cancer-related immunosuppression: ASCO and IDSA clinical practice guideline update. J Clin Oncol. 2018;36:3043–54.CrossRef
6.
go back to reference Kuderer NM, Dale DC, Crawford J, et al. Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer. 2006;106:2258–66.CrossRef Kuderer NM, Dale DC, Crawford J, et al. Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer. 2006;106:2258–66.CrossRef
7.
go back to reference Carmona-Bayonas A, Jimenez-Fonseca P, Virizuela Echaburu J, et al. Prediction of serious complications in patients with seemingly stable febrile neutropenia: validation of the clinical index of stable febrile neutropenia in a prospective cohort of patients from the FINITE study. J Clin Oncol. 2015;33:465–71.CrossRef Carmona-Bayonas A, Jimenez-Fonseca P, Virizuela Echaburu J, et al. Prediction of serious complications in patients with seemingly stable febrile neutropenia: validation of the clinical index of stable febrile neutropenia in a prospective cohort of patients from the FINITE study. J Clin Oncol. 2015;33:465–71.CrossRef
8.
go back to reference Baden LR, Swaminathan S, Angarone M, et al. Prevention and treatment of cancer-related infections, version 2.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Cancer Netw. 2016;14:882–913.CrossRef Baden LR, Swaminathan S, Angarone M, et al. Prevention and treatment of cancer-related infections, version 2.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Cancer Netw. 2016;14:882–913.CrossRef
9.
go back to reference Dalal M, Gupta J, Price K, et al. Efficacy and safety of front-line treatments for advanced Hodgkin lymphoma: a systematic literature review. Expert Rev Hematol. 2020;13:907–22.CrossRef Dalal M, Gupta J, Price K, et al. Efficacy and safety of front-line treatments for advanced Hodgkin lymphoma: a systematic literature review. Expert Rev Hematol. 2020;13:907–22.CrossRef
10.
go back to reference Borchmann P, Goergen H, Kobe C, et al. PET-guided treatment in patients with advanced-stage Hodgkin’s lymphoma (HD18): final results of an open-label, international, randomised phase 3 trial by the German Hodgkin Study Group. Lancet. 2018;390:2790–802.CrossRef Borchmann P, Goergen H, Kobe C, et al. PET-guided treatment in patients with advanced-stage Hodgkin’s lymphoma (HD18): final results of an open-label, international, randomised phase 3 trial by the German Hodgkin Study Group. Lancet. 2018;390:2790–802.CrossRef
18.
go back to reference Carvalho AS, Lagana D, Catford J, et al. Bloodstream infections in neutropenic patients with haematological malignancies. Infect Dis Health. 2020;25:22–9.CrossRef Carvalho AS, Lagana D, Catford J, et al. Bloodstream infections in neutropenic patients with haematological malignancies. Infect Dis Health. 2020;25:22–9.CrossRef
19.
go back to reference Al-Tawfiq JA, Hinedi K, Khairallah H, et al. Epidemiology and source of infection in patients with febrile neutropenia: a ten-year longitudinal study. J Infect Public Health. 2019;12:364–6.CrossRef Al-Tawfiq JA, Hinedi K, Khairallah H, et al. Epidemiology and source of infection in patients with febrile neutropenia: a ten-year longitudinal study. J Infect Public Health. 2019;12:364–6.CrossRef
21.
go back to reference Chan KH, Lee PW, Chan CY, et al. Monitoring respiratory infections in covid-19 epidemics. BMJ. 2020;369:m1628.CrossRef Chan KH, Lee PW, Chan CY, et al. Monitoring respiratory infections in covid-19 epidemics. BMJ. 2020;369:m1628.CrossRef
Metadata
Title
Impact of the first COVID-19 lockdown in Germany on the rate of acute infections during intensive chemotherapy for Hodgkin lymphoma
Authors
Anne Sophie Jacob
Helen Kaul
Michael Fuchs
Sarah Gillessen
Stefanie Kreissl
Annette Pluetschow
Jesko Momotow
Valdete Schaub
Andreas Huettmann
Mathias Haenel
Andreas Zimmermann
Judith Dierlamm
Julia Meissner
Stephan Mathas
Sonja Martin
Andreas Engert
Michael Hallek
Peter Borchmann
Clara Lehmann
Publication date
19-02-2022
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 4/2022
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-022-01765-3

Other articles of this Issue 4/2022

Infection 4/2022 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Webinar | 06-02-2024 | 20:00 (CET)

Mastering chronic pancreatitis pain: A multidisciplinary approach and practical solutions

Severe pain is the most common symptom of chronic pancreatitis. In this webinar, experts share the latest insights in pain management for chronic pancreatitis patients. Experts from a range of disciplines discuss pertinent cases and provide practical suggestions for use within clinical practice.

Sponsored by: Viatris

Developed by: Springer Healthcare