Correlation between CD4 lymphocytes count and the opportunistic infections in treated glioblastoma.

Abstract

2102 Background: Less than 200 CD4 lymphocytopenia happens frequently with temozolomide treatment of glioblastoma. This immunosuppression is associated with many opportunistic infections and antibiotic prophylaxis is given in some centers to prevent Pneumocystis pneumonia. Methods: We analyzed the association between documented culture-proved infections and CD4 lymphocytes level in 140 patients treated with temozolomide in first-line glioblastoma in Notre-Dame Hospital from 2006 to 2009. Demographic and treatment data were collected and analyzed with Kaplan-Meier survival plots and Log Rank tests. Results: The cohort of infected patients was represented by 31 patients who developed 49 culture-proved infections: 21 urinary origin, 8 pulmonary (1 Pneumocytis and 2 Aspergillosis), 5 brain, 5 bacteremia and 2 other. The infected cohort (n=31) had similar demographs, but also similar outcome compared to our control non infected glioblastoma treated patients cohort (n=109) with a 2 year survival of 40.8% vs 50.2% (p=). The median CD4 lymphocytes level was 260, but clearly infections were associated with less than 200 CD4 lymphocytes. During their infection, 20 patients had a CD4 level less than 200, compared with 11 patients with more than 200 CD4 lymphocytes count. Conclusions: CD4 lymphocytopenia less than 200 is associated with increase in number of documented culture-proven infections in patients treated with temozolomide, but the survival is not altered by the infection.