[血液病患者肝脾念珠菌病的临床特征和预后]。

D P Zhu, R Ma, Y He, X Y Luo, W Han, C Li, J R Zhou, Y Liao, B R Tang, Q L T Longka, X J Huang, Y Q Sun
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引用次数: 0

摘要

肝脾念珠菌病(HSC)是一种罕见的念珠菌病,可发生在血液系统恶性肿瘤和造血干细胞移植患者身上。目前,有关血液系统疾病患者 HSC 的研究还很缺乏。根据《中国血液病和肿瘤患者侵袭性真菌病诊治指南》(第 6 版),我们回顾性分析了 2008 年至 2022 年在北京大学血液病研究所接受治疗的 HSC 患者的临床特征和预后。最后,我们纳入了 18 例患者,其中 1 例(5.6%)已证实为造血干细胞,2 例(11.1%)可能为造血干细胞,15 例(83.3%)可能为造血干细胞。其中,3 例(16.7%)患者发生在单倍体造血干细胞移植后,15 例(83.3%)患者发生在化疗后。6例(33.3%)患者血液培养呈阳性,其中4例为热带念珠菌,2例为白色念珠菌。抗真菌治疗 4 周后,10 例(58.8%)患者获得部分应答,8 周后,1 例(6.3%)患者获得完全应答,10 例(62.5%)患者获得应答。确诊后 6 个月,3 名患者(16.7%)死于造血功能复发,其中没有人死于造血干细胞。作为一种罕见的真菌感染性疾病,HSC 的微生物学和组织学检查阳性率低,治疗周期长,缓解困难,提醒我们需要警惕造血障碍和持续发热患者。
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[Clinical features and prognosis of hepatosplenic candidiasis in patients with hematopathy].

Hepatosplenic candidiasis (HSC) is a rare type of candidiasis that can occur in patients with hematologic malignancies, hematopoietic stem cell transplantation. At present, there is still a lack of studies on HSC in patients with hematologic disorders. Based on The Chinese Guidelines for the Diagnosis and Treatment of Invasive Fungal Disease in Patients with Hematological Disorders and Cancers (the 6th revision), We retrospectively analyzed the clinical characteristics and prognosis of patients with HSC treated in Peking University Institute of Hematology from 2008 to 2022. Finally, eighteen patients were included, with 1 (5.6%) proven, 2 (11.1%) probable, and 15 (83.3%) possible HSC. Among them, 3 (16.7%) patients occurred after haploid hematopoietic stem cell transplantation and 15 (83.3%) patients occurred after chemotherapy. 6 (33.3%) patients had positive blood cultures, including 4 cases of Candida tropicalis and 2 cases of Candida albicans. At 4 weeks of antifungal therapy, 10 (58.8%) patients achieved partial response (PR), At 8 weeks, 1 (6.3%) patients achieved complete response and 10 (62.5%) patients achieved PR. At 6 months after diagnosis, 3 (16.7%) patients died of hematopoietic recurrence, and none of them died of HSC. As a rare fungal infection disease, HSC has a low positive rate of microbiological and histological examinations, a persistent treat cycle, and has difficulty in remission, reminding us of the need for vigilance in patients with hematopoietic disorders and persistent fever.

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