免疫缺陷是 B 细胞恶性肿瘤的共同特征。感染的风险及其诊断后的预后意义已得到很好的表征，但相反，人们对这些领域的诊断前感染知之甚少。在匹配的病例对照分析中，使用丹麦全国登记册，我们评估了慢性淋巴细胞白血病的诊断前感染率。白血病 (CLL)、弥漫性大 B 细胞淋巴瘤 (DLBCL)、多发性骨髓瘤 (MM)、滤泡性淋巴瘤 (FL)、边缘区淋巴瘤 (MZL) 和淋巴浆细胞淋巴瘤 (LPL)。然后使用临床登记数据的生存分析来确定诊断前一年的感染对总体生存的影响。为了为尽可能多的患者提供结果，抗菌药物处方被用作感染的替代指标。全国登记册和临床登记册分别包括 30,389 名患者（累计 213,649 张抗菌处方）和 18,560 名患者（累计 107,268 张处方）。恶性肿瘤诊断前 15 年，感染的相对风险增加，并且在诊断前一年显着增加。诊断前一年内使用两种以上抗菌药物与显着缩短总生存期相关，与已知的预后因素无关。患有 B 细胞源性恶性肿瘤的患者在诊断前几年就表现出明显的免疫缺陷，因此不同的疾病亚型表现出重叠和不同的趋势诊断前的感染风险。此外，诊断前一年内的多次感染与所有检查的恶性肿瘤的总生存期较短独立相关。© 2024。作者。

Immunodeficiency is a shared feature of B cell malignancies. The risk of infections and their prognostic significance after diagnosis are well characterized, but, conversely, less is known about prediagnostic infections in these domains.In matched case-control analyzes, using Danish nationwide registers, we assessed the rate of prediagnostic infections in chronic lymphocytic leukemia (CLL), diffuse large B cell lymphoma (DLBCL), multiple myeloma (MM), follicular lymphoma (FL), marginal zone lymphoma (MZL), and lymphoplasmacytic lymphoma (LPL). Survival analyzes of data from clinical registers were then used to determine the effect of infections in the year preceding diagnosis on overall survival. To yield results for as many patients as possible, antimicrobial prescriptions were used as surrogates for infections.The nationwide and clinical registers comprised 30,389 patients, accumulating 213,649 antimicrobial prescriptions, and 18,560 patients accumulating 107,268 prescriptions, respectively. The relative risk of infections was increased up to 15 years prior to diagnosis of malignancy and markedly increased in the year just prior to diagnosis. More than two antimicrobials within one year prior to diagnosis were associated with significantly shorter overall survival, independently of known prognostic factors.Patients with B cell-derived malignancies exhibit marked immunodeficiency several years prior to diagnosis such that different disease subtypes demonstrate both overlapping and distinct trends in infection risk preceding diagnosis. Moreover, multiple infections within the year preceding diagnosis are independently associated with shorter overall survival for all the examined malignancies.© 2024. The Author(s).