Early T-Cell Precursor Leukemia Has a Higher Risk of Induction-Related Infection among T-Cell Acute Lymphoblastic Leukemia in Adult.
Early T-Cell Precursor Leukemia Has a Higher Risk of Induction-Related Infection among T-Cell Acute Lymphoblastic Leukemia in Adult.
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成人 T 细胞急性淋巴细胞白血病中，早期 T 细胞前体白血病发生诱导相关感染的风险较高
DOI：
10.1155/2020/8867760
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发表时间：
2020
影响因子：
4.6
通讯作者：
Zhou H
中科院分区：
文献类型：
--
作者：
Huang K;Dai M;Li Q;Liu N;Lin D;Wang Q;Zhou X;Wang Z;Gao Y;Jin H;Liu X;Liu Q;Zhou H
感染是急性淋巴细胞白血病（ALL）发病和死亡的重要原因。然而，关于诱导化疗期间成人T-ALL诱导相关感染风险因素的报告大致未知/有限。 我们对参加PDT-ALL-LBL临床试验的连续T-ALL患者（N = 97）进行了一项回顾性队列研究，以了解诱导相关感染的患病率和风险预测因素。在97例入组试验的T-ALL患者中，46例为早期T细胞前体（ETP）ALL，51例为非ETP ALL。 与非ETP相比，ETP ALL亚型的中性粒细胞计数（1.35 × 109/L vs.8.7 × 109/L，P < 0.001）和骨髓粒细胞百分比（13.35% vs.35.31%，P = 0.007）较低。此外，ETP ALL在诊断前（P < 0.001）和诱导化疗期间（P < 0.001）的中性粒细胞减少时间较长。值得注意的是，ETP队列的临床记录感染累积发生率较高（CDI; 33.33%，P = 0.001），微生物学记录的感染ETP组中MDI（45.24%，P = 0.006）、耐药感染（11.9%，P = 0.013）和混合感染（21.43%，P = 0.003）的发生率明显高于非ETP组。多因素分析显示，T-ALL混合感染与化疗疗效相关性更高（OR，0.025; 95%CI 0.127-0.64; P = 0.012），并确定髓系百分比是与ETP-ALL混合感染相关的预测因子（OR，0.915; 95% CI 0.843-0.993; P = 0.033），ETP队列中ROC定义的临界值为2.24%。 我们的数据首次表明，在T-ALL人群中，以骨髓细胞生成受损为特征的ETP-ALL更容易发生诱导相关感染。
Infections are an important cause of morbidity and mortality for acute lymphoblastic leukemia (ALL). However, the reports regarding risk factors of induction-related infection are roughly unknown/limited in adult T-ALL during induction chemotherapy. We performed a retrospective cohort study for the prevalence and risk predictors of induction-related infection among consecutive T-ALL patients (N = 97) enrolled in a PDT-ALL-LBL clinical trial. Of 97 patients with T-ALL enrolled in the trial, 46 were early T-cell precursor (ETP) ALL and 51 were non-ETP ALL. When compared with non-ETP, ETP ALL subtype was characterized with lower neutrophil count (1.35 × 109/L vs. 8.7 × 109/L, P < 0.001) and lower myeloid percentage in the bone marrow (13.35% vs. 35.31%, P = 0.007). Additionally, ETP ALL had longer neutropenia before diagnosis (P < 0.001), as well as during induction chemotherapy (P < 0.001). Notably, the ETP cohort experienced higher cumulative incidence of clinically documented infections (CDI; 33.33%, P = 0.001), microbiologically documented infections (MDI; 45.24%, P = 0.006), resistant infection (11.9%, P = 0.013), and mixed infection (21.43%, P = 0.003), respectively, than those of the non-ETP cohort. Furthermore, multivariable analysis revealed that T-ALL mixed infection was more likely related to chemotherapy response (OR, 0.025; 95% CI 0.127-0.64; P = 0.012) and identified myeloid percentage as a predictor associated with ETP-ALL mixed infection (OR, 0.915; 95% CI 0.843-0.993; P = 0.033), with ROC-defined cut-off value of 2.24% in ETP cohorts. Our data for the first time demonstrated that ETP-ALL characterized with impaired myelopoiesis were more susceptible to induction-related infection among T-ALL populations.
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影响因子：
12.8
作者：
Bochennek, K.;Hassler, A.;Lehrnbecher, T.
通讯作者：
Lehrnbecher, T.
影响因子：
11.8
作者：
Dix, David;Cellot, Sonia;Sung, Lillian
通讯作者：
Sung, Lillian
影响因子：
20.3
作者：
Sung, Lillian;Lange, Beverly J.;Feusner, James
通讯作者：
Feusner, James
影响因子：
20.3
作者：
De Obaldia, Maria Elena;Bell, J. Jeremiah;Bhandoola, Avinash
通讯作者：
Bhandoola, Avinash
影响因子：
20.3
作者：
Maude, Shannon L.;Dolai, Sibasish;Teachey, David T.
通讯作者：
Teachey, David T.