PROLONGED GRANULOCYTOPENIA - THE MAJOR RISK FACTOR FOR INVASIVE PULMONARY ASPERGILLOSIS IN PATIENTS WITH ACUTE-LEUKEMIA
PROLONGED GRANULOCYTOPENIA - THE MAJOR RISK FACTOR FOR INVASIVE PULMONARY ASPERGILLOSIS IN PATIENTS WITH ACUTE-LEUKEMIA
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DOI：
10.7326/0003-4819-100-3-345
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发表时间：
1984-01-01
影响因子：
39.2
通讯作者：
CASSILETH, PA
中科院分区：
文献类型：
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作者：
GERSON, SL;TALBOT, GH;CASSILETH, PA
通过回顾15例经病理证实的侵袭性肺曲霉病患者和45例对照患者的病史，对急性白血病患者进行了一项病例对照研究，以确定侵袭性肺曲霉病的重要危险因素。肺部或鼻窦疾病病史、吸烟以及白血病多次复发并不会增加侵袭性肺曲霉病的风险。病例组和对照组接受了相似的化疗方案，接触氨基糖苷类、羧苄青霉素、复方磺胺甲恶唑或皮质类固醇与侵袭性肺曲霉病的发生并无显著关联。在测试的因素中，只有粒细胞减少症与侵袭性肺曲霉病的发生有关。在粒细胞减少症病程早期，患者出现侵袭性肺曲霉病症状的比率约为每天1%。随着粒细胞减少持续时间的增加，该比率上升，在第24天到第36天之间约为每天4.3%。在粒细胞减少持续28天的13例患者中，有7例出现了侵袭性肺曲霉病的症状。对于急性白血病患者来说，粒细胞减少持续超过3周是发生侵袭性肺曲霉病的主要危险因素。
A case-control study of patients with acute leukemia was done to identify significant risk factors for invasive pulmonary aspergillosis by reviewing the medical histories of 15 cases of pathologically proven invasive pulmonary aspergillosis and 45 controls. A history of lung or sinus disease, smoking and multiple recurrences of leukemia did not increase the risk of invasive pulmonary aspergillosis. Cases and controls received similar chemotherapeutic regimens, and exposure to aminoglycosides, carbenicillin, trimethoprim-sulfamethoxazole or corticosteroids was not significantly associated with development of invasive pulmonary aspergillosis. Among the factors tested, only granulocytopenia was associated with development of invasive pulmonary aspergillosis. Early in the course of granulocytopenia, patients developed signs of invasive pulmonary aspergillosis at a rate of .apprx. 1%/day. As the duration of granulocytopenia increased, the rate increased, approximating 4.3%/day between the 24th and 36th days. Of the 13 patients remaining granulocytopenic at 28 days, 7 had developed signs of invasive pulmonary aspergillosis. For patients with acute leukemia, graunlocytopenia persisting longer than 3 wk is the major risk factor for developing invasive pulmonary aspergillosis.