QUANTITATIVE RELATIONSHIPS BETWEEN CIRCULATING LEUKOCYTES AND INFECTION IN PATIENTS WITH ACUTE LEUKEMIA
QUANTITATIVE RELATIONSHIPS BETWEEN CIRCULATING LEUKOCYTES AND INFECTION IN PATIENTS WITH ACUTE LEUKEMIA
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DOI：
10.7326/0003-4819-64-2-328
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发表时间：
1966-01-01
影响因子：
39.2
通讯作者：
FREIREICH, EJ
中科院分区：
文献类型：
--
作者：
BODEY, GP;BUCKLEY, M;FREIREICH, EJ
本文报告52例急性白血病患者的粒细胞和淋巴细胞水平。共考虑了17，743个患者日。这些患者在62%的时间内处于急性白血病的骨髓缓解期。粒细胞减少症（小于1000每立方毫米）和淋巴细胞减少症经常发生，即使在缓解期。随着粒细胞水平的增加，确定感染的时间百分比下降。这种关系适用于复发和缓解期间，但在复发期间，每个粒细胞水平的感染时间比例更大。淋巴细胞也存在类似的关系。低粒细胞或淋巴细胞水平（低于500/立方毫米）的时间比例随着感染类型的加重而增加。虽然发生感染的风险与粒细胞和淋巴细胞水平有关，但粒细胞水平显然更重要。粒细胞减少症较淋巴细胞减少症更易发生感染。36%的严重传染病（肺炎、尿路感染、败血症、播散性真菌感染等）与前一周粒细胞水平下降有关。在任何一周内，粒细胞水平下降的所有事件中有12%以严重感染告终。任何粒细胞减少症的发作，无论其持续时间如何，都有39%的机会导致确定的感染。随着粒细胞减少症持续时间的延长，风险增加。严重感染引起随后的粒细胞水平下降的频率与引起粒细胞水平升高的频率相同。复发和缓解期粒细胞对感染的反应相似。粒细胞水平持续低于每立方毫米100粒细胞的患者严重感染的病死率最高。粒细胞水平升高对感染有反应的患者病死率较低。
The granulocyte and lymphocyte levels of 52 patients with acute leukemia were tabulated during their entire illness. A total of 17, 743 patient days were considered. The patients were in bone marrow remission of their acute leukemia during 62% of the time. Granulocytopenia (less than 1000 per cu mm) and lymphopenia occurred frequently, even during remission. The percentage of time spent with identified infection decreased with increasing granulocyte levels. This relationship applied both during relapse and remission, but the proportion of time spent with infection at every granulocyte level was greater during relapse. Similar relationships existed for lymphocytes. The proportion of time spent with low granulocyte or lymphocyte levels (less than 500 per cu mm) increased with increasingly severe types of infection. Although the risk of developing infection was related to both granulocyte and lymphocyte levels, the granulocyte level was clearly more important. Infection occurred more often with granulocytopenia alone than with lymphopenia alone. Thirty-six per cent of severe infectious episodes (pneumonias, urinary tract infections, septicemias, disseminated fungal infections, etc.) were associated with a fall in granulocyte level during the preceding week. Twelve per cent of all episodes of falling granulocyte levels during any one-week period terminated in severe infection. Any episode of granulocytopenia, regardless of its duration, had a 39% chance of resulting in identified infection. As the duration of granulocytopenia lengthened, the risk increased. Severe infection caused a subsequent fall in the granulocyte level as frequently as it caused an increase. The granulocyte response to infection was similar during relapse and remission. The fatality rate for severe infection was highest for patients who had granulocyte levels persistently less than 100 per cu mm. The fatality rate was lower for patients who responded to infection with a rise in their granulocyte level.