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- Title
Posttreatment Lymphopenia Is Associated With an Increased Risk of Redeveloping Nontuberculous Lung Disease in Patients With Mycobacterium avium Complex Lung Disease.
- Authors
Furuuchi, Koji; Fujiwara, Keiji; Uesgi, Fumiko; Shimoda, Masafumi; Seto, Shintaro; Tanaka, Yoshiaki; Yoshiyama, Takashi; Yoshimori, Kozo; Kurashima, Atsuyuki; Ohta, Ken; Morimoto, Kozo
- Abstract
Background Lymphopenia has been reported as a risk factor for poor prognosis in various infectious diseases, including Mycobacterium avium complex lung disease (MAC-LD), and recurrence in several infectious diseases. However, the association between lymphopenia and the risk of redeveloping nontuberculous lung disease (NTM-LD) after completed treatment for MAC-LD is unknown. Methods We performed a retrospective cohort study with 147 patients with MAC-LD who successfully completed guideline-based therapy. Lymphopenia was defined as an absolute lymphocyte count (ALC) <1000 cells/μL based on commonly accepted reference values. Results During the median follow-up period of 41.9 months after treatment completion, 59 (40.1%) patients redeveloped NTM-LD. Patients with NTM-LD redevelopment had significantly lower posttreatment ALCs (median, 1260 vs 1420 cells/μL) than those without, and the univariate Cox proportional hazard analysis identified posttreatment ALC as a predictive factor for redevelopment (hazard ratio,.94 [95% confidence interval,.89–.99] for every increase of 100 cells/μL; P =.04). In the multivariate analysis, posttreatment ALC and the extent of bronchiectasis were independently associated with NTM-LD redevelopment. The cumulative rate of NTM-LD redevelopment was significantly higher in patients with posttreatment lymphopenia than in those without (P =.008). Conclusions Posttreatment lymphopenia could predict an increased risk of NTM-LD redevelopment after completed treatment for MAC-LD.
- Subjects
DISEASE relapse; MYCOBACTERIAL disease treatment; LUNG disease treatment; REFERENCE values; PATIENT aftercare; STATISTICS; CONFIDENCE intervals; LUNG diseases; MULTIVARIATE analysis; RETROSPECTIVE studies; LYMPHOPENIA; RISK assessment; DESCRIPTIVE statistics; MYCOBACTERIAL diseases; BRONCHIECTASIS; LONGITUDINAL method; LYMPHOCYTE count; PROPORTIONAL hazards models; DISEASE risk factors; DISEASE complications
- Publication
Clinical Infectious Diseases, 2021, Vol 73, Issue 1, pe152
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciaa729