Leuk Lymphoma:AML和MDS患者:万古霉素耐药肠球菌获得和感染的风险因素

2017-08-15 梁舒瑶 环球医学资讯

2017年11月,发表在《Leuk Lymphoma》的一项由美国科学家进行的回顾性研究,考察了在伊达比星和阿糖孢苷诱导化疗的急性髓性白血病(AML)和骨髓增生异常综合征(MDS)患者中,万古霉素耐药肠球菌(VRE)获得和感染的风险因素。

2017年11月,发表在《Leuk Lymphoma》的一项由美国科学家进行的回顾性研究,考察了在伊达比星和阿糖孢苷诱导化疗的急性髓性白血病(AML)和骨髓增生异常综合征(MDS)患者中,万古霉素耐药肠球菌(VRE)获得和感染的风险因素。

研究人员进行了回顾性研究,以确定在近期诊断并使用伊达比星和阿糖孢苷7+3方案进行化疗的AML和MDS患者中,与VRE获得/感染相关的风险因素。尽管只有2.5%(6/235)的患者在入院时定植了VRE,但59%(134/229)的患者在住院期间获得了VRE。多变量分析确定静脉注射万古霉素(p=0.024;HR:1.548)和头孢菌素(p=0.009;HR:1.596)作为VRE获得的风险因素。14%(33/229)的患者发生VRE感染,其中血液感染占病例的82%(27/33)。VRE定植患者中,25/126名(20%)发生VRE感染,而在非定植患者中只有8/103名(8%)(p=0.01)。本研究为静脉注射头孢菌素和万古霉素对VRE获得的作用提供了证据,并强调了在这些患者中VRE定植的临床意义。

原始出处:
Heisel RW, Sutton RR, Mascara GP,et al.Vancomycin-resistant enterococci in acute myeloid leukemia and myelodysplastic syndrome patients undergoing induction chemotherapy with idarubicin and cytarabine.Leuk Lymphoma. 2017 Nov;58(11):2565-2572. doi: 10.1080/10428194.2017.1306645. Epub 2017 Mar 28.

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    2017-12-22 d830372
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    2017-08-15 1e145228m78(暂无匿称)

    学习了,谢谢作者分享!

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急性骨髓性白血病(AML)经标准“3+7”方案诱导化疗后完全缓解率可达60%-80%,长期生存率20%-40%。但仍有10%-40%的患者存在原发耐药,取得完全缓解的患者还有相当的比例会复发。目前国际上对于初始诱导失败和复发AML患者尚无统一的挽救治疗方案。2017年6月,发表在《Leukemia》的一项研究调查了挽救治疗方案对诱导失败的AML患者应答和总生存的影响。 研究者评价了挽救方案和异基