Clinical factors predictive of mortality in acute leukemia patients with febrile neutropenia

AJBR Copyright © 2021..

BACKGROUND: Acute leukemia is mainly treated with chemotherapy leading to febrile neutropenia (FN). There is limited data on clinical factors predictive of mortality in adults with acute leukemia and FN.

METHODS: This was a retrospective cohort study and enrolled adult patients, diagnosed as acute leukemia, and developed FN. The eligible patients were admitted and followed up with mortality as the primary outcome. A stepwise, multivariate logistic regression analysis was used to find predictors for mortality.

RESULTS: There were 203 patients met the study criteria. Of those, 14 patients died (6.89%). AML was the most common type of acute leukemia with FN (64.04%). There were five remaining factors in the final model: AML, FN at admission, prolong broad spectrum antibiotics, lower respiratory tract infection, and Aspergillosis. Only lower respiratory tract infection was significant with adjusted odds ratio of 7.794 (95% CI of 1.549, 39.212). The Hosmer-Lemeshow Chi square was 2.74 (p value 0.907). The lower respiratory tract infection group had higher proportions of Gram negative and fungus than the non-lower respiratory tract infection group; specifically E. coli (p 0.003), and Aspergillus (P < 0.001).

CONCLUSIONS: There were two independent predictors of mortality in acute leukemia patients with FN: septic shock and lower respiratory tract infection regardless of leukemia type or pathogen. E. coli and Aspergillus were more common in those with lower respiratory tract infection than those without. No specific pathogens were found in cases of septic shock.

Medienart:

Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:11

Enthalten in:

American journal of blood research - 11(2021), 1 vom: 01., Seite 59-65

Sprache:

Englisch

Beteiligte Personen:

Wanitpongpun, Chinadol [VerfasserIn]
Teawtrakul, Nattiya [VerfasserIn]
Lanamtieng, Theerin [VerfasserIn]
Chansung, Kanchana [VerfasserIn]
Sirijeerachai, Chittima [VerfasserIn]
Amampai, Worakamol [VerfasserIn]
Sawanyawisuth, Kittisak [VerfasserIn]

Themen:

Acute myeloid leukemia
Aspergillus
Escherichia
Journal Article

Anmerkungen:

Date Revised 03.04.2021

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM323518923