Infectious Risk Based on Contraceptive Method in Women With New Cancer Diagnoses: Are Indwelling Methods Riskier? [6O]. (May 2016) - Prokai, David
Abstract : INTRODUCTION: To determine if indwelling contraceptive methods such as long-acting reversible contraceptives (LARC) contribute to increased incidence of infectious sequelae as compared to non-indwelling methods (oral contraceptives, transdermal methods) in women with new diagnosis of hematologic cancers such as leukemia and lymphoma. METHODS: Retrospective case review of new cancer diagnoses registered to the institutional tumor registry between November 20, 2012 and May 27, 2014 were evaluated. Patients reporting breast and gynecologic malignancies were excluded. The main outcome assessment was neutropenic fever, which was considered representative of infectious sequelae. Results were stratified based on type of cancer. Chi-square test was used to evaluate statistical significance. RESULTS: A total of 197 patients were identified. Sixty six patients were excluded for incomplete records, and 22 were gynecologic cancers. Seventy two patients reported solid cancer; 37 reported hematologic cancer. Of these women with hematologic cancers, 22 women used short-acting hormonal methods of contraception. Of these, 10/22 were noted to have treatment-related infectious complication. Twelve women were identified as using LARC; 6/22 were noted to have treatment-related infectious complication. Two patients in this group reported hysterectomy and had treatment-related infectious complication. CONCLUSION: Critics of indwelling LARC propose that indwelling contraceptive methods may pose increased risk of infectious sequelae in patients who are undergoing leukemia and lymphoma treatment and anticipate neutropenia. Our data supports no increased risk of infectious complication in women undergoing chemotherapy for leukemia and lymphoma based on the contraceptive method used. Given these data, a provider should consider the use of LARC in this high-risk, specialized population.