半隔离化疗室治疗急性髓细胞白血病

Cosphiadi Irawan, Ricci Steven, Ralph Girson Gunarsa, Jeffry Beta Tenggara
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摘要

白血病(LMA)。白血病患者LMA半隔离治疗的研究。这项研究利用了Mochtar Riady癌症综合中心诊断LMA的医学研究数据摘要简介。标准的正压隔离室在印度尼西亚还没有普及。在几家私立医院,目前的最佳做法是将患者送入半隔离室,并采取额外的防护措施。尽管有局限性,但这种做法被认为是安全的,可能有益于急性髓细胞白血病(AML)患者。本研究旨在分析入住半隔离室的AML患者的白血病特征和生存率。方法。使用2018年至2020年间在Mochtar Riady综合癌症中心诊断的AML患者的医疗记录中的二次数据进行了一项回顾性队列研究。将患者分为半隔离室组和非隔离室组。根据并发症、结果和生存率,对接受标准化疗方案的半隔离室患者进行进一步分析。后果我们纳入了45名AML患者,53.3%为女性,42.2%为40-59岁年龄组,28.9%为AML-M2。15例患者在半隔离室接受标准化疗方案,包括D3A7、FLAG、ATRA柔红霉素-阿糖胞苷,其中60%的患者在治疗完成后完全缓解。未入住半隔离室的患者接受了保守治疗,包括羟基脲、巯基嘌呤、阿糖胞苷细胞减少和地西他滨。在半隔离室的患者中,41.2%的患者患有败血症,29.4%的患者患有感染性休克,其中大多数来源于血液感染(80%),鲍曼不动杆菌仍然是最常见的微生物。治疗结果显示,中位无进展生存期(PFS)为11个月,1年生存期为47%,2年生存率为27%。结论。在标准隔离室有限的国家,可以考虑在具有感染控制方案的半隔离室中治疗AML患者,以提供标准的诱导化疗方案。尽管存在感染风险,但严格的隔离政策产生了良好的反应(60%完全缓解)。
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Luaran Hasil Leukemia Mieloid Akut yang Menjalani Terapi pada Ruang Kemoterapi Semi-Isolasi
Leukemia (LMA). Studi leukemia kesintasan pasien LMA yang diadmisi ruang rawat semi-isolasi. Studi kohort retrospektif menggunakan data sekunder rekam medis pasien yang terdiagnosis LMA pada Mochtar Riady Comprehensive Cancer Center ABSTRACT Introduction . Standard positive pressure isolation room is not yet widely available in Indonesia. In several private hospitals, current best practice is admitting patients to semi-isolation room with additional protective measures. Despite the limitation, this practice is considered safe and might benefit Acute Myeloid Leukemia (AML) patients. This study aimed to analyze the leukemic profile and survival in AML patients admitted to semi-isolation room. Methods . A retrospective cohort study was conducted using secondary data from medical record of AML patients diagnosed in Mochtar Riady Comprehensive Cancer Center between 2018 – 2020. Patients were divided into semi-isolation room group and not admitted to semi-isolation room group. Semi-isolation room patients who received standard chemotherapy regimen were further analyzed according to complication, outcome, and survival. Results. We included 45 AML patients, 53.3% were females, 42.2% in the 40-59 years age group, and 28.9% were AML-M2. Fifteen patients received standard chemotherapy regimen including D3A7, FLAG, ATRA-Daunorubicin-Cytarabine in semi-isolation room, 60% of them had complete remission after treatment completion. Patients who not admitted to semi-isolation room received conservative treatments including hydroxyurea, mercaptopurine, cytarabine cytoreduction, and decitabine. Among patients in semi-isolation room, 41.2% had sepsis and 29.4 % had septic shock, with most of the sources coming from bloodstream infection (80%), Acinetobacter baumannii remained the most prevalent microorganism. Treatment outcomes showed median Progression Free Survival (PFS) of 11 months, 1-year survival was 47%, and 2-year survival was 27%. Conclusions. In countries with limited standard isolation room, treatment of AML patients in semi-isolation room with infection control protocol could be considered in order to give the standard induction chemotherapy regimen. Although there was an infection risk, strict isolation policy produced good response (60% complete remission).
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