较低的尿酸和充足的水分与淋巴瘤患者自体骨髓移植后较低的发热性中性粒细胞减少症风险有关

Babak Nejati, Zohreh Kourehpaz, Roya Dolatkhah, Mojtaba Varshochi, Maryam Farmani, Alireza Parviz
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摘要

背景。尽管自体骨髓移植(BMT)治疗淋巴瘤患者的结果令人鼓舞,但感染性并发症限制了其积极结果。本研究评估了淋巴瘤患者行BMT后发热性中性粒细胞减少症(FN)的发生率及其相关因素。材料和方法。总体而言,147例候选BMT的淋巴瘤患者被连续纳入。记录临床和实验室结果,并在BMT后通过每日中性粒细胞计数和体温的评估来调查FN的发生。术后平均12.77±2.45 d发生FN 91例(61.9%)。较低的体液平衡与较高的FN风险相关(第2天的最低调整优势比[OR] = 0.602, 95%可信区间[CI] = 0.299 - 0.870, p值= 0.007)。较高的尿酸水平与较高的FN风险相关(第10天最高调整OR = 1.617, 95% CI = 1.328 - 1.963, p值= 0.035)。LDH也与FN呈正相关(第0天最高调整OR = 1.501, 95% CI = 1.198 ~ 2.104, p值= 0.004)。在接受BMT的患者中,充足的水分对于预防FN至关重要。此外,尿酸和LDH可以在未来的研究中考虑FN的风险分层。
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Lower uric acid and adequate hydration are associated with lower risk of febrile neutropenia following autologous bone marrow transplantation in patients with lymphoma
Background. Despite promising results of autologous bone marrow transplantation (BMT) in patients with lymphoma, infectious complications limit its positive outcomes. This study evaluated the incidence and associated factors of the occurrence of febrile neutropenia (FN) following BMT in patients with lymphoma. Material and methods. Overall, 147  lymphoma patients who were candidates for BMT were consecutively included. Clinical and laboratory results were recorded, and after BMT, the occurrence of FN was investigated through the daily evaluation of neutrophil count and body temperature. Results. FN occurred in 91 patients (61.9 %) on average after 12.77 ± 2.45 days after BMT.  Lower fluid balance was associated with a higher risk of FN (lowest adjusted odds ratio [OR] at day -2 = 0.602, 95% confidence interval [CI] = 0.299 – 0.870, p value = 0.007). The higher uric acid level was associated with a higher risk of FN (highest adjusted OR at day -10 = 1.617, 95% CI = 1.328 – 1.963, p value = 0.035). LDH also had a positive relationship with FN (highest adjusted OR at day 0 = 1.501, 95% CI = 1.198 – 2.104, p value = 0.004). Conclusion. Adequate hydration of the patients is of paramount importance for preventing FN in patients who receive BMT. Furthermore, uric acid and LDH could be considered in future studies for risk stratification of FN.
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