title: [Effects of peri-immunosupressive therapy period infection on hematologic response and survival of severe aplastic anemia].
abstract: OBJECTIVE
  To explore the effects of peri-immunosuppressive treatment（IST）infection on outcomes of severe and very severe aplastic anemia（SAA/VSAA）patients.
  
  
  METHODS
  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.
  
  
  RESULTS
  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）.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Ye
authors.affiliation: Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Jing
authors.affiliation: Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: Wenrui
authors.initials: W
authors.lastname: Yang
authors.affiliation: Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: Kang
authors.initials: K
authors.lastname: Zhou
authors.affiliation: Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: Guangxin
authors.initials: G
authors.lastname: Peng
authors.affiliation: Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Li
authors.affiliation: Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Song
authors.affiliation: Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: Zhijie
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: Fengkui
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000741:Anemia, Aplastic; D005334:Fever; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D007166:Immunosuppressive Agents