Infections et cytopénies… impact sur et de l’immunothérapie

Abstract

Febrile neutropenia consists of a major complication of lung cancer chemotherapy. The frequent association of COPD with lung cancer supports the hospital management of such event. Frequency and potential severity of bacterial infections support the use of an early probabilistic antibiotic therapy. Its choice relies on the knowledge of local bacterial epidemiology and of the local profile of bacterial resistances to antibiotics, the presence of patient severity criteria or risk factors for a severe infection. The time to apyrexia and aplasia exit determines the eventual adaptations and length of antibiotic treatment. Antibiotic prophylaxis is not recommended anymore for prevention of febrile neutropenia. Primary prophylaxis with hematopoietic growth factors is recommended, according to the type of chemotherapy, to age, and the presence of progressive tumor disease.The occurrence of immune checkpoint-induced neutropenia is rare but often severe. Antibiotic prescription in the 60 days flanking the initiation of immunotherapy was evidenced to impair the efficacy such immunotherapy due to its effect on gut microbiota.1877-1203/© 2022 SPLF. Published by Elsevier Masson SAS. All rights reserved.