Prognostic factors influencing infection-related mortality in patients with acute leukemia in Korea.
We retrospectively reviewed the medical records of 284 patients with neutropenic fever following chemotherapy for acute leukemia at the Catholic Hematopoietic Stem Cell Transplantation Center from January 1998 to December 1999, to identify prognostic factors for infection-related mortality. Twenty-eight patients died of infections. There was no difference in median age, gender ratio, or underlying disease between the dying and surviving groups. Bacteria were the main pathogens following chemotherapy, and Gram positive organisms predominated in the dying group. Pneumonia and sepsis were the main causes of death. There were 72 cases of invasive fungal infection and their mortality was 27.8%. Invasive fungal infection and previous history of fungal infection were independent prognostic factors for outcome. Recovery from neutropenia was the significant protective factor for mortality. In conclusion, the prognostic factors identified in this study could be useful for deciding on more intensive treatment for those patients at greater risk of death. To our knowledge, this is the first Korean study delineating prognostic factors in acute leukemic patients with infectious complications.
Yoo
Jin-Hong
JH
The Catholic Hemopoietic Stem Cell Transplantation Center, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Choi
Su Mi
SM
Lee
Dong-Gun
DG
Choi
Jung-Hyun
JH
Shin
Wan-Shik
WS
Min
Woo-Sung
WS
Kim
Chun-Choo
CC
D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000150:complications / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D006801:Humans; D007723:Korea; D007938:Leukemia; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000382:microbiology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015999:Multivariate Analysis; D009181:Mycoses / Q000150:complications / Q000401:mortality; D009503:Neutropenia; D011014:Pneumonia / Q000150:complications / Q000401:mortality; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000382:microbiology* / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications / Q000401:mortality; D015996:Survival Rate
Semin Oncol. 1997 Feb;24(1):132-40
9045299
Ann Intern Med. 1972 Nov;77(5):707-14
4628214
Cancer. 1996 Feb 15;77(4):791-8
8616774
Clin Infect Dis. 2002 Mar 15;34(6):730-51
11850858
Infect Dis Clin North Am. 1996 Dec;10(4):777-96
8958168
Clin Infect Dis. 1994 Mar;18(3):390-4
8011821
Infection. 2000 Nov-Dec;28(6):367-73
11139156
Clin Infect Dis. 1999 Sep;29(3):490-4
10530434
Infect Dis Clin North Am. 2001 Jun;15(2):457-82
11447706
Am Rev Respir Dis. 1976 Sep;114(3):593-627
184728
Clin Infect Dis. 1997 Aug;25(2):247-59
9332520
Ann Intern Med. 1966 Feb;64(2):328-40
5216294
Arch Intern Med. 1985 Sep;145(9):1621-9
3927867
Diagn Microbiol Infect Dis. 1999 Jul;34(3):221-7
10403102
Clin Infect Dis. 1998 Apr;26(4):781-803; quiz 804-5
9564455
Clin Infect Dis. 2002 Jan 1;34(1):7-14
11731939
Arch Intern Med. 2000 Feb 28;160(4):501-9
10695690
Med Oncol. 2000 May;17(2):111-6
10871816
Bone Marrow Transplant. 2004 Sep;34(6):497-504
15286689
Ann Hematol. 2003 Oct;82 Suppl 2:S105-17
13680173
Curr Opin Infect Dis. 1998 Aug;11(4):401-9
17033402
Am J Med. 1986 May 30;80(5C):13-20
3521270
N Engl J Med. 1999 Sep 16;341(12):893-900
10486422