급성 백혈병 환자에서 관해 유도 치료 시 일반 병실과 보호된 환경의 감염률 비교
Comparative Study on the Infection Rates of Protected Environment versus Non-Protected Environment in Acute Myeloid Leukemia during Remission Induction Chemotherapy
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Background and purpose Patients with acute leukemia experience prolonged periods of neutropenia due to their disease or its treatment. For this reason, they often develop serious infectious complications. Although antibiotic therapy has improved in recent years, the fatality rate from infection remains high. For the control of infection, protected environment was developed. But because of economic issue, most of chemotherapy with acute myeloid leukemia have conducted in non-protected environment. So this study compared the rate of complete remission, days with neutropenia, rate of fever, rate of positive culture, rate of overt infection and use of antibacterial and antifungal agents with patients within non-protected environment and protected environment, retrospectively. Patients with acute myeloid leukemia during first remission induction chemotherapy were eligible for this study. Methods Retrospective analysis was conducted between patients in non-protected (25 patients) and protected environment (14 patients) with acute myeloid leukemia during remission induction chemotherapy. Results Rate of overt infection, rate of fever, rate of positive culture and rate of use of antibiotics were significantly high in patients within non-protected environment compared with patients within protected environment. There were no differences in rate of complete remission and days of neutropenia. Conclusions This study suggests protected environment for patients with acute myeloid leukemia during remission induction chemotherapy could reduce rate of overt infection, and rate of use of antibiotics.
Abstract
Background and purpose Patients with acute leukemia experience prolonged periods of neutropenia due to their disease or its treatment. For this reason, they often develop serious infectious complications. Although antibiotic therapy has improved in recent years, the fatality rate from infection remains high. For the control of infection, protected environment was developed. But because of economic issue, most of chemotherapy with acute myeloid leukemia have conducted in non-protected environment. So this study compared the rate of complete remission, days with neutropenia, rate of fever, rate of positive culture, rate of overt infection and use of antibacterial and antifungal agents with patients within non-protected environment and protected environment, retrospectively. Patients with acute myeloid leukemia during first remission induction chemotherapy were eligible for this study. Methods Retrospective analysis was conducted between patients in non-protected (25 patients) and protected environment (14 patients) with acute myeloid leukemia during remission induction chemotherapy. Results Rate of overt infection, rate of fever, rate of positive culture and rate of use of antibiotics were significantly high in patients within non-protected environment compared with patients within protected environment. There were no differences in rate of complete remission and days of neutropenia. Conclusions This study suggests protected environment for patients with acute myeloid leukemia during remission induction chemotherapy could reduce rate of overt infection, and rate of use of antibiotics.
참고문헌 (15)
- Bodey GP, "Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia", Ann Intern Med, 64(2), pp.328~340 (1966)
- Chang HY, "Causes of death in adults with acute leukemia", Medicine, 55(3), pp.259~268 (1976)
- Klastersky J, "The multinational association for supportive care in cancer risk index: a multinational scoring system for identifying low-risk febrile neutropenic cancer patients", J Clin Oncol, 18(16), pp.3038~3051 (2000)
- Madani TA, "Clinical infections and bloodstream isolates associated with fever in patients undergoing chemotherapy for acute myeloid leukemia", Infection, 28(6), pp.367~373 (2000)
- Yates G, "Laminar air for cancer patients", Contamination Control, 7(10), pp.20~24 (1968)
- Penland WZ, Jr, "Portable laminar- air-flow isolator", Lancet, 1(7639), pp.174~176 (1970)
- Bodey GP, "Studies of a patient isolator unit and prophylactic antibiotics in cancer chemotherapy", General techniques and preliminary results Cancer, 22(5), pp.1018~1026 (1968)
- Bodey GP, "Effect of prophylactic measures on the microbial flora of patients in protected environment units", Medicine, 53(3), pp.209~228 (1974)
- Bodey GP, "Microbiological studies of a laminar air flow unit for patients", Arch Environ Health, 19(6), pp.798~805 (1969)
- Hughes WT, "2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Infectious Diseases Society of America", Clin Infect Dis, 34(6), pp.730~751 (2002)
- Schimpf SC, "Infection prevention in acute nonlymphocytic leukemia", Ann Intern Med, 82(3), pp.351~358 (1975)
- Bodey GP, "Protected environment-prophylactic antibiotic program in the chemotherapy of acute leukemia", Am J Med Sci, 262(3), pp.138~151 (1971)
- Yates JW, "A controlled study of isolation and endogenous microbial suppression in acute myelocytic leukemia patients", Cancer, 32(6), pp.1490~1498 (1973)
- Klastersky J, "Use of oral antibiotics in protected units environment: clinical effectiveness and role in the emergence of antibiotic-resistant strains", Pathol Biol, 22(1), pp.5~12 (1974)
- Lohner D, "Comparative randomized study of protected environment plus oral antibiotics versus oral antibiotics alone in neutropenic patients", Cancer Treat Rep, 63(3), pp.363~368 (1979)