急性白血病患者的侵袭性肺曲霉病。

Q3 Medicine Tunisie Medicale Pub Date : 2024-09-05 DOI:10.62438/tunismed.v102i9.4770
Olfa Kassar, Aicha Ben Kahla, Yosra Fakhefakh, Wiem Feki, Fatma Cheikhrouhou, Moez Elloumi
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引用次数: 0

摘要

导言目的:描述急性白血病患者IPA病例的发病率、诊断方面、治疗方式和演变情况:我们的研究是回顾性的,包括2009年1月至2020年12月期间在突尼斯南部血液科发生侵袭性肺曲霉菌病的急性白血病患者。根据 EORTC / MSG 2019 标准,IPA 被定义为三个可能性等级:结果:我们共收集了 127 例侵袭性肺曲霉菌病患者。63%的患者患有急性髓性白血病。76%的病例在诱导过程中被诊断为侵袭性肺曲霉菌病。27 名患者出现胸痛。89%的病例在胸部计算机断层扫描(CT)中显示出晕征。38%的病例中曲霉菌半乳甘露聚糖抗原呈阳性。18%的病例出现肺外曲霉菌病:分别有 59% 和 41% 的病例可能和可能患有 IPA。所有患者均接受了伏立康唑治疗,54%的病例取得了良好的疗效。死亡率为 46%。第 12 周的总生存率为 56%:结论:在我们的系列研究中,侵袭性肺曲霉菌病合并急性白血病患者的发病率和死亡率都很高。我们需要改进早期诊断和治疗策略。
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Invasive pulmonary aspergillosis in patients with acute leukemia.

Introduction: Invasive pulmonary aspergillosis is a serious complication in hematology.

Aim: Describe the prevalence, diagnostic aspects, therapeutic modalities, and evolution of the IPA cases occurring in patients with acute leukemia.

Methods: Our study was retrospective including patients with acute leukemia who developed invasive pulmonary aspergillosis during the period January 2009 and December 2020 at the hematology department in south Tunisia. The IPA was defined in three levels of probability according to the criteria of the EORTC / MSG 2019.

Results: We collected 127 patients who presented with Invasive pulmonary aspergillosis. Sixty-three percent of our patients had acute myeloid leukemia. The diagnosis of invasive pulmonary aspergillosis was during the induction course in 76% of cases. Twenty-seven of our patients had chest pain. The chest Computed tomography (CT) scan showed the Halo sign in 89% of cases. The Aspergillus galactomannan antigen was positive in 38% of cases. Extrapulmonary aspergillosis involvement was noted in 18% of cases: IPA was possible and probable respectively in 59% and 41% of cases. All patients treated with Voriconazole with a favorable response in 54% of cases. The mortality rate was 46%. The overall survival at week 12 was 56%.

Conclusion: The morbidity and mortality of patients who developed invasive pulmonary aspergillosis with acute leukemia in our series were high. We need to improve our strategy for early diagnosis and management.

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来源期刊
Tunisie Medicale
Tunisie Medicale Medicine-Medicine (all)
CiteScore
1.00
自引率
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发文量
72
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