Cytomegalovirus Reactivation in Diffuse Large B-cell Lymphoma Treated with Polatuzumab Vedotin:

A Retrospective Study

Abstract

　　Cytomegalovirus reactivation (CMVR) frequently complicates treatment with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). In the POLARIX clinical trial, polatuzumab vedotin (Pola) is the standard treatment for diffuse large B-cell lymphoma (DLBCL), but Pola with R-CHP (Pola-R-CHP) is associated with a higher incidence of febrile neutropenia than R-CHOP. However, real-world evidence is lacking. We retrospectively analyzed 72 patients with DLBCL with International Prognostic Index risk score ≥2 who received R-CHOP (n＝60) or Pola-R-CHP (n＝12) at our institution and examined the frequency of CMVR and lymphopenia in these patients. Patient characteristics were similar between the groups. None of the patients in the R-CHOP group had CMVR complications, whereas 2 patients in the Pola-R-CHP group developed CMVR. However, there was no significant difference between the two groups (p＝0.476). Although no significant difference in the frequency of lymphopenia was observed between the two groups (p＝0.446) , the 2 patients in the Pola-R-CHP group who developed CMVR had prolonged lymphopenia. This study showed that the frequency of CMVR and lymphopenia did not significantly differ between R-CHOP and Pola-R-CHOP. However, we report two unusual cases of CMVR and prolonged lymphopenia after Pola-R-CHP. Special attention should be paid to patients with multiple risk factors for CMVR.