Severe novel influenza A (H1N1) infection in cancer patients
Severe novel influenza A (H1N1) infection in cancer patients
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DOI：
10.1093/annonc/mdq254
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发表时间：
2010-12-01
影响因子：
50.5
通讯作者：
Hoff, P. M.
中科院分区：
文献类型：
--
作者：
Hajjar, L. A.;Mauad, T.;Hoff, P. M.
患者和方法：回顾了所有因新型H1N1病毒感染导致急性呼吸衰竭的患者的临床资料。肺组织进行病毒和细菌学分析，通过实时RT-PCR，并进行尸检，对所有患者死亡。结果：8例患者入院，年龄从55岁到65岁。有5名患者患有实体器官肿瘤（62.5%），3名患者患有血液系统恶性肿瘤（37.5%）。5名患者需要机械通气，全部死亡。4例患者有细菌性支气管肺炎。所有死亡均因多器官衰竭而发生。在三名幸存者中存在较轻形式的肺部疾病。对所有患者进行肺组织分析，大多数患者显示弥漫性肺泡损伤。其他肺部表现为坏死性细支气管炎或广泛出血。结论：H1N1病毒感染的癌症患者可引起严重的疾病，导致急性呼吸窘迫综合征和死亡。需要更多的数据来确定这些患者不利进展的预测因素。
Patients and methods: Clinical data from all patients admitted with acute respiratory failure due to novel viral H1N1 infection were reviewed. Lung tissue was submitted for viral and bacteriological analyses by real-time RT-PCR, and autopsy was conducted on all patients who died.Results: Eight patients were admitted, with ages ranging from 55 to 65 years old. There were five patients with solid organ tumors (62.5%) and three with hematological malignancies (37.5%). Five patients required mechanical ventilation and all died. Four patients had bacterial bronchopneumonia. All deaths occurred due to multiple organ failure. A milder form of lung disease was present in the three cases who survived. Lung tissue analysis was performed in all patients and showed diffuse alveolar damage in most patients. Other lung findings were necrotizing bronchiolitis or extensive hemorrhage.Conclusions: H1N1 viral infection in patients with cancer can cause severe illness, resulting in acute respiratory distress syndrome and death. More data are needed to identify predictors of unfavorable evolution in these patients.