Effects of peri-immunosupressive therapy period infection on hematologic response and survival of severe aplastic anemia / 中华血液学杂志
Chinese Journal of Hematology
; (12): 670-675, 2015.
Article
in Chinese
| WPRIM (Western Pacific)
| ID: wpr-296177
Responsible library:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To explore the effects of peri-immunosuppressive treatment(IST)infection on outcomes of severe and very severe aplastic anemia(SAA/VSAA)patients.</p><p><b>METHODS</b>Medical record and follow-up data of 105 SAA/VSAA who underwent first-line IST were retrospectively analyzed to find out the characters of infections(1 month before to 3 months after IST), and its effects on hematologic response and survival.</p><p><b>RESULTS</b>Of 105 patients, a total of 270 febrile episodes were recorded in 97 patients(92.4%)during their peri- IST periods, with the median infections of 2(1-7)episodes in each patient with the median febrile duration of 7(1-47)days. Respiratory system(35.1%)was the primary anatomic site of infection. Bacteria(88.2%)were common causes of total 169 pathogenic bacteria in 96 clear pathogenic bacteria episodes. And patients who got infection 1 month before IST had much lower 6- month hematologic response rate than their counterpart ones(50.8% vs 80.0%, P=0.004). Multiple febrile episodes ( ≥3 times) and the total febrile duration ≥4 days showed the best sensitivity and specificity according to the ROC curve analysis. The 5-year overall survival of the 105 patients was 76%. The 5- year OS of patients with multiple febrile episodes ( ≥3 times) were much lower than their counterpart ones[(59.6±7.2)% vs(89.5±4.0)%](P<0.01). The 5-year OS of the total febrile duration ≥4 days was much lower than their counterpart ones[(63.4±5.8)% vs 100.0%](P<0.01).</p><p><b>CONCLUSION</b>Infections 1 month before IST were associated with hematologic response. Multiple febrile episodes(≥3 times) and infections with the febrile duration ≥4 days presented inferior hematologic response and survival.</p>
Full text:
Available
Database:
WPRIM (Western Pacific)
Main subject:
Retrospective Studies
/
ROC Curve
/
Follow-Up Studies
/
Fever
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Immunosuppressive Agents
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Anemia, Aplastic
Type of study:
Observational study
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Prognostic study
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Risk factors
Limits:
Humans
Language:
Chinese
Journal:
Chinese Journal of Hematology
Year:
2015
Document type:
Article