Impact of vancomycin-resistant enterococcal bacteremia on outcome during acute myeloid leukemia induction therapy
Impact of vancomycin-resistant enterococcal bacteremia on outcome during acute myeloid leukemia induction therapy
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DOI：
10.3109/10428194.2014.1003557
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发表时间：
2015-01-01
影响因子：
2.6
通讯作者：
Sekeres, Mikkael A.
中科院分区：
文献类型：
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作者：
Ornstein, Moshe C.;Mukherjee, Sudipto;Sekeres, Mikkael A.
本研究旨在了解急性髓系白血病(AML)患者在接受诱导化疗(IC)时，万古霉素耐药肠球菌(VRE)菌血症的发生率及其影响。350例患者中有37例(10.6%)在IC期间出现VRE菌血症，在研究期间VRE菌血症的发生率呈上升趋势。队列的总体完全缓解率(CR)为73%，VRE菌血症和非VRE菌血症队列的CR率无差异(70%对73%，P=0.70)。未调整的中位总生存期(OS)为12.8个月，有VRE菌血症和无VRE菌血症患者的中位生存期分别为7.1个月和13.1个月，差异有统计学意义(P=0.03)。急性髓细胞白血病IC期间VRE菌血症的存在与全因死亡率的增加独立相关(危险比1.72，95%可信区间1.13-2.63，p=0.01)。
This study aimed to identify the rate and impact of vancomycin-resistant enterococcal (VRE) bacteremia in patients with acute myeloid leukemia (AML) receiving induction chemotherapy (IC). Thirty-seven (10.6%) of 350 patients had VRE bacteremia during IC, with increasing rates of VRE bacteremia over the course of the study period. The overall complete remission (CR) rate for the cohort was 73%, and there was no difference in CR rate between the VRE bacteremia and non-VRE bacteremia cohorts (70% vs. 73%, p = 0.70). Unadjusted median overall survival (OS) was 12.8 months, and differed significantly between those with and without VRE bacteremia (7.1 months vs. 13.1 months, respectively; p = 0.03). The presence of VRE bacteremia during IC for AML was independently associated with increased all-cause mortality (hazard ratio 1.72, 95% confidence interval 1.13-2.63, p = 0.01).