{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T04:49:05Z","timestamp":1792558145279,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Infection and lymphopenia are established bendamustine\u2010related complications. The relationship between lymphopenia severity and infection risk, and the role of antimicrobial prophylaxis, is not well described. This multicentre retrospective study analysed infection characteristics and antimicrobial prophylaxis in 302 bendamustine\u2010treated indolent non\u2010Hodgkin lymphoma patients. Lymphopenia (&lt;1\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L) was near universal and time to lymphocyte recovery correlated with cumulative bendamustine dose. No association between lymphopenia severity and duration with infection was observed. Infections occurred in 44% of patients (50% bacterial) with 27% hospitalised; 32% of infections occurred \u22653\u2009months post bendamustine completion. Infection was associated with obinutuzumab and\/or maintenance anti\u2010CD20 therapy, prior therapy and advanced stage. Twenty\u2010four opportunistic infections occurred in 21 patients: ten varicella zoster virus (VZV), seven herpes simplex virus (HSV), one cytomegalovirus, one progressive multifocal leucoencephalopathy, one nocardiosis, one <jats:italic>Pneumocystis jiroveci<\/jats:italic> pneumonia (PJP) and three other fungal infections. VZV\/HSV and PJP prophylaxis were prescribed to 42% and 54% respectively. Fewer VZV\/HSV infections occurred in patients receiving prophylaxis (HR 0.14, <jats:italic>p<\/jats:italic>\u2009=\u20090.061) while PJP prophylaxis was associated with reduced risk of bacterial infection (HR 0.48, <jats:italic>p<\/jats:italic>\u2009=\u20090.004). Our study demonstrates a significant infection risk regardless of lymphopenia severity and supports prophylaxis to mitigate the risk of early and delayed infections.<\/jats:p>","DOI":"10.1111\/bjh.19407","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T20:24:29Z","timestamp":1710447869000},"page":"146-157","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Infection risk and antimicrobial prophylaxis in bendamustine\u2010treated patients with indolent non\u2010Hodgkin lymphoma: An Australasian Lymphoma Alliance study"],"prefix":"10.1111","volume":"205","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6880-2876","authenticated-orcid":false,"given":"Kate","family":"Manos","sequence":"first","affiliation":[{"name":"Department of Haematology Flinders Medical Centre  Bedford Park South Australia 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Monash Health  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usha","family":"Chandra\u00a0Sekaran","sequence":"additional","affiliation":[{"name":"Department of Haematology Fiona Stanley Hospital  Murdoch Western Australia Australia"},{"name":"Pathwest Laboratory  Nedlands Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Wight","sequence":"additional","affiliation":[{"name":"Department of Haematology and Bone Marrow Transplantation Townsville Hospital and Health Service  Townsville Queensland Australia"},{"name":"Division of Tropical Health and Medicine James Cook University  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Haematology Gold Coast University Hospital  Southport Queensland 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