Clinical characteristics and influencing factors of infections in acute lymphoblastic leukemia patients during chemotherapy
Objective To explore the clinical characteristics,high-risk factors,and intervention strategies of infections in pa-tients with acute lymphoblastic leukemia(ALL)during chemotherapy,aiming to provide evidence for clinical treatment.Methods A total of 106 patients with ALL admitted from September 2019 to September 2022 were selected as the study participants.Information on the participants was collected,including age,gender,length of hospital stay,hospitalization season,infection site,pathogen detection results,laboratory indicators,and chemotherapy conditions.The clinical charac-teristics of ALL patients after infection were analyzed,and the differences in clinical characteristics between infected and non-infected patients were explored.Factors with significant differences in univariate analysis were subjected to uncondition-al logistic stepwise regression analysis.Results Among the 106 ALL patients,61 patients experienced infections,with an infection rate of 57.55％.Among the 61 infected patients,a total of 82 infections were noted,and most patients were infec-ted only once(68.85％).Among all 82 infections in patients,single-site infections were predominant(54.88％),with the respiratory tract being a common infection site(29.27％).Overall,31 pathogenic strains were detected,mainly Gram-negative bac-teria(45.16％).Unconditional logistic stepwise regression analysis results indicated that age ≥45 years(95％CI=1.179-3.069,OR=1.902,P=0.009),length of hospital stay ≥14 days(95％CI=1.127-3.037,OR=1.850,P=0.015),chemotherapy sessions ≥2 times(95％CI=1.383-3.004,OR=2.038,P＜0.001),being in the induction period(95％CI=1.129-2.848,OR=1.793,P=0.014),neutrophil deficiency duration ≥7 days(95％CI=1.074-2.236,OR=1.550,P=0.020),minimum hemoglobin＜60 g/L(95％CI=1.042-2.946,OR=1.752,P=0.035),and not using prophy-lactic antimicrobial drugs(95％CI=1.273-2.300,OR=1.711,P＜0.001)are independent risk factors affecting infec-tions during ALL chemotherapy.Conclusion Age ≥45 years,length of hospital stay≥14 days,chemotherapy sessions≥2 times,being in the induction period,neutrophil deficiency duration ≥7 days,minimum hemoglobin＜60 g/L,and not u-sing prophylactic antimicrobial drugs are independent risk factors affecting infections during chemotherapy of adults with ALL.Clinically,control measures should be taken against the risk factors of infections during chemotherapy against ALL to reduce the impact of infections on patients with ALL during chemotherapy.
万方数据
维普
