Neutropenic fever and severe sepsis in adult acute myeloid leukemia (AML) patients receiving intensive chemotherapy:: Causes and consequences

被引：60

作者：

Hamalainen, Sari ^{[1
]}

Kuittinen, Taru ^{[1
]}

Marinlauri, Irma ^{[2
]}

Nousiainen, Tapio ^{[1
]}

Koivula, Irma ^{[1
]}

Jantunen, Esa ^{[1
]}

机构：

[1] Kuopio Univ Hosp, Dept Med, Kuopio 70211, Finland

[2] Kuopio Univ Hosp, Clin Chem, Kuopio 70211, Finland

来源：

LEUKEMIA & LYMPHOMA | 2008年 / 49卷 / 03期

关键词：

neutropenic fever; severe sepsis; AML; microbial etiology; CRP; blood cultures;

D O I：

10.1080/10428190701809172

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

The objective of this study was to evaluate etiology and consequences of neutropenic fever in AML patients. Two hundred and ninety neutropenic periods following chemotherapy in 84 AML patients were retrospectively evaluated. Neutropenic fever was found in 280 periods (97%). Severe sepsis developed in 35 occasions (13%) and 9 patients (11%) died due to severe sepsis. In 165 episodes with neutropenic fever (59%), the potential causative organism was found in blood cultures. Gram-negative bacteria were more commonly found in patients who developed severe sepsis (40% vs. 23%, p=0.03). CRP after 2-3 days from start with fever was higher in patients with severe sepsis (190mg/L vs. 96mg/L, p < 0.001) but the rise in CRP rather coincided than preceded with the development of severe sepsis. Severe sepsis is associated with significant mortality in AML patients. Earlier methods than CRP are needed to predict development of severe sepsis.

引用

页码：495 / 501

页数：7

共 29 条

[1]

Arber C, 2000, SCAND J INFECT DIS, V32, P515, DOI 10.1080/003655400458802

[2] AMERICAN-COLLEGE OF CHEST PHYSICIANS SOCIETY OF CRITICAL CARE MEDICINE CONSENSUS CONFERENCE - DEFINITIONS FOR SEPSIS AND ORGAN FAILURE AND GUIDELINES FOR THE USE OF INNOVATIVE THERAPIES IN SEPSIS [J].

BONE, RC ;

BALK, RA ;

CERRA, FB ;

DELLINGER, RP ;

FEIN, AM ;

KNAUS, WA ;

SCHEIN, RMH ;

SIBBALD, WJ ;

ABRAMS, JH ;

BERNARD, GR ;

BIONDI, JW ;

CALVIN, JE ;

DEMLING, R ;

FAHEY, PJ ;

FISHER, CJ ;

FRANKLIN, C ;

GORELICK, KJ ;

KELLEY, MA ;

MAKI, DG ;

MARSHALL, JC ;

MERRILL, WW ;

PRIBBLE, JP ;

RACKOW, EC ;

RODELL, TC ;

SHEAGREN, JN ;

SILVER, M ;

SPRUNG, CL ;

STRAUBE, RC ;

TOBIN, MJ ;

TRENHOLME, GM ;

WAGNER, DP ;

WEBB, CD ;

WHERRY, JC ;

WIEDEMANN, HP ;

WORTEL, CH .

CRITICAL CARE MEDICINE, 1992, 20 (06) :864-874

[3]

Burnett Alan K, 2002, Rev Clin Exp Hematol, V6, P26

[4] Intensified induction chemotherapy in adult acute myeloid leukemia followed by high-dose chemotherapy and autologous peripheral blood stem cell transplantation: an Eastern Cooperative Oncology Group trial (E4995) [J].

Cassileth, PA ;

Lee, SJ ;

Litzow, MR ;

Miller, KB ;

Stadtmauer, EA ;

Tallman, MS ;

Lazarus, HM ;

Bennett, JM ;

Paietta, E ;

Dewald, GW ;

Rowe, JM .

LEUKEMIA & LYMPHOMA, 2005, 46 (01) :55-61

[5]

CASTAIGNE S, 2004, HAEMATOLOGICA, V89, P950

[6]

Cherif Honar, 2003, Hematol J, V4, P420, DOI 10.1038/sj.thj.6200334

[7] Comparison between four and eight cycles of intensive chemotherapy in adult acute myeloid leukemia:: a randomized trial of the Finnish Leukemia Group [J].

Elonen, E ;

Almqvist, A ;

Hänninen, A ;

Jansson, SE ;

Järventie, G ;

Koistinen, P ;

Koivunen, E ;

Lahtinen, R ;

Lehtinen, M ;

Nousiainen, T ;

Pelliniemi, TT ;

Rajamäki, A ;

Remes, K ;

Timonen, T ;

Vilpo, J ;

Volin, L ;

Ruutu, T .

LEUKEMIA, 1998, 12 (07) :1041-1048

[8]

Erten Nilgun, 2004, J Chin Med Assoc, V67, P217

[9]

FERREIRA FL, 2001, JAMA-J AM MED ASSOC, V10, P1754

[10] 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer [J].

Hughes, WT ;

Armstrong, D ;

Bodey, GP ;

Bow, EJ ;

Brown, AE ;

Calandra, T ;

Feld, R ;

Pizzo, PA ;

Rolston, KVI ;

Shenep, JL ;

Young, LS .

CLINICAL INFECTIOUS DISEASES, 2002, 34 (06) :730-751

← 1 2 3 →