Pneumonia in acute leukemia patients during induction therapy: experience in a single institution.
Pneumonia is still a complication leading to high morbidity and mortality rates in acute leukemia (AL) patients. To evaluate the incidence, risk factors and outcome of pneumonia in a single institution we retrospectively studied 288 patients observed between 1994 and 2000, affected by AL (218 acute myeloblastic leukemia and 70 acute lymphoblastic leukemia [ALL]) treated with an anthracycline-containing induction regimen. Of 288 patients, 80 (27.7%) developed pneumonia: 67/80 had acute myelogenous leukemia (AML) and 13/80 had ALL. At univariate analysis only advanced age correlated with the risk of pneumonia (P < 0.001). Of the 80 pneumonia cases, 25 (31.2%) were microbiologically documented and 65 (68.8%) were clinically demonstrated; pneumonia responded to treatment in 44/80 (55%) patients; among the patients with positive outcome of their pneumonia 33/44 (75%) achieved complete remission whereas only 2/36 (5%) patients with a negative outcome achieved complete remission. At multivariate analysis the determinants of positive outcome of pneumonia were younger age (P < 0.05), the achievement of complete remission (P < 0.005) and the recovery of neutrophils (P < 0.005).
Specchia
Giorgina
G
Hematology Section, Department DIMIMP, University of Bari, Piazza Giulio Cesare 11, Bari, 70124 Italy. emadhba@cimedoc.uniba.it
Pastore
Domenico
D
Carluccio
Paola
P
Mele
Giuseppe
G
Montagna
Maria Teresa
MT
Liso
Arcangelo
A
Rizzi
Rita
R
Ianora
Amatoantonio Stabile
AS
Liso
Vincenzo
V
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015994:Incidence; D007938:Leukemia / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009503:Neutropenia; D011014:Pneumonia / Q000139:chemically induced* / Q000453:epidemiology / Q000209:etiology; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic