5.Clinical Analysis of 164 Children of Blood Disease Complicated with Invasive Fungal Disease.
Xiong-Yu LIAO ; Kun-Yin QIU ; Ruo-Hao WU ; Shu-Yi GUO ; Jian WANG ; Ke HUANG ; Hong-Gui XU ; Yang LI ; Jian-Pei FANG ; Dun-Hua ZHOU
Journal of Experimental Hematology 2019;27(5):1672-1677
OBJECTIVE:
To investigate the clinical characteristics, prevention and treatment of invasive fungal disease (IFD).
METHODS:
The clinical data of 164 patients who met the diagnostic criteria of IFD in our center from January 2012 to January 2015 were retrospectively analyzed. The incidence, clinical characteristics, related factors, treatment methods and prognosis were analyzed.
RESULTS:
Among 1289 cases of blood diseases, 164 cases suffered from IFD with inciduce of 12.7%. The main infection sites were as followed: lung, blood and gastrointestinal tract, with incidence of 84.2%, 5.5% and 3% respectively. The funge was found in 35 cases by detection; among fungi, the detected rate of candida albicans. aspergillus and candida glabrata was more high with 51.5%, 20% and 14.3% respectively. Among 164 childen with blood deseases complicated by IFD, 36 cases gained complete remission, 97 cases gained partial remission, 10 cases were stable, 11 cases were progressive and 10 cases died, the overall effective rate reached 81.1%. The univariate analysis showed that the gramulopenia, granulocyte recovery, long-term use of corticosteroid and immuno-suppressive agents, as well as different grades of diagnosis were significant factors affecting the efficacy of antifungal therapy for blood disease children with IFD, the multivariate analysis further showed that the granulocyte recovery and diagnosis grades were independent prognostic factors affecting the therapeutic efficacy for IFD children. The overall survival rate of IFD children with 12 weeks of antifungal treatnment was 81.7%, out of which the survival rate of IFD children at 12 weeks of treatment with itraconazole, voriconazole, amphotericin B and caspofungin was 81.4%, 80%, 69.4% and 97.1% respectively, there were significant differences in survival rate between each other by long rank test. In addition of caspofungin, the other 3 kinds of drugs had toxic side effects of different degrees, but IFD children could tolerated these effects after symptomatic treatment.
CONCLUSION
The incidence of IFD in children with blood deseases in our hospital is 12.7%, the lung is most common infective site, moreover patogens of IFD mainly is candida. The promotion of granulocyte recovery and early stratified diagnosis can contribule to the treatment of IFD. For the IFD children with better economic condition, the caspofungin is a potent antifungal agent with high efficacy, low toxicity and better prognosis.
Amphotericin B
;
Antifungal Agents
;
Child
;
Hematologic Diseases
;
etiology
;
Humans
;
Invasive Fungal Infections
;
complications
;
Retrospective Studies
7.Risk Analysis of Catheter-related Bloodstream Infection and Thrombosis in Patients with Blood Diseases Undergoing Peripheral Introvascular Central Catheter (PICC).
Bin FAN ; Fen HUANG ; Yu-Hong ZHANG ; Gan-Hong MEI
Journal of Experimental Hematology 2019;27(1):272-276
OBJECTIVE:
To evaluate the effects of peripheral introvascular central catheters (PICC) on the catheter-associated bloodstream infections (CRBSI) and the formations of catheter-related bloodstream infections.
METHODS:
Total of 483 patients with hematologic malignancies admitted in our hospital from January 2013 to December 2016 were enrolled in this study, and 612 PICC catheterization were conducted. The median time of catheterization was 101 d (48 ∼ 184 d) . The incidence rates of CRBSI and CRTC were observed, and the CRBSI and CRTC associated variables were also analyzed.
RESULTS:
There were 47 cases of CRBSI (7.7%), and the incidence was 0.59‰ PICC days, and there were 16 cases of CRTC (2.6%), with the incidence of 0.20‰ PICC days. Meanwhile, no other related serious complications found. The Cox regression analysis of CRBSI and CRTC-associated variables showed that the acute leukemia was significantly related with a higher incidence of CRBSI as compared with the other type of disease, however, which was not significantly related with the CRTC.
CONCLUSION
Compared with the traditional CVAD catheterization, the PICC is more safe and effective for the patients with malignant tumors, thus which may become a alternative method for CVAD.
Catheter-Related Infections
;
etiology
;
Catheterization, Central Venous
;
adverse effects
;
Hematologic Diseases
;
Humans
;
Incidence
;
Risk Factors
;
Thrombosis
;
etiology
8.Pulmonary fungal infection in children with malignant hematological disease: an analysis of 17 cases.
An-Sheng LIU ; Ju-Ping PANG ; Yi SUN ; Xu-Qing WANG ; Dan LI ; Wen-Jin GAO
Chinese Journal of Contemporary Pediatrics 2008;10(2):239-240
Adolescent
;
Child
;
Child, Preschool
;
Female
;
Hematologic Neoplasms
;
complications
;
Humans
;
Infant
;
Lung Diseases, Fungal
;
drug therapy
;
etiology
;
Male
9.Clinical features of hematological abnormality in systemic lupus erythematosus-related hematological disorders.
Journal of Experimental Hematology 2002;10(4):359-361
In order to investigate the clinical characteristics of hematological abnormality in patients with systemic lupus erythematosus (SLE) and inquire into the basis for differential diagnosis, the hematological data of 92 cases with lupus erythematosus-related hematological disorder (SLERHD) were retrospectively analyzed by use of SPSS/PC software. The results showed that these patients were short of specificity in clinical manifestation and hemogram, however, all cases possessed multiple SLE-related autoantibodies, increase of serum globulin level and varying extent dermal and arthral signs. The incidence of primary or initial symptom in the 92 cases was as follow: 65 anemia (72.8%), 39 purpura (42.4%), 17 hemolytic anemia (18.5%), 56 leukopenia (60.9%), 54 thrombocytopenia (58.7%), and 41 pancytopenia (44.6%). The bone marrow examinations showed that the cellularity of nucleated cells was mostly normal, and active proliferation in 57 cases (61.9%) and hypercellularity in 35 cases (38.1%); the G/E ratio was normal in majority, and G/E ratio > 3 in 59 cases (64.1%) and < 3 in 33 cases (35.9%) and G/E < 1 in 17 cases with hemolytic anemia Coombs' test positive; megakaryocyte counts were normal in 11 cases (11.9%), increase in 80 cases (86.9%) and lower than 7/marrow smear in 1 case (1.1%). Neutrophil alkaline phosphatase staining was negative in all of the cases. From above data it is concluded that patients with SLERHD are varied in clinical and blood pictures, but all patients are provided with multiple SLE-related autoantibodies, globulinemia and dermal and arthral signs. It is easy to identify SLERHD from aplastic anemia, myelodysplastic syndrome, idiopathic thrombocytopenic purpura, autoimmune hemolytic anemia and Evans' syndrome by comprehensive and detailed clinical and laboratory examinations.
Adolescent
;
Adult
;
Bone Marrow Examination
;
Female
;
Hematologic Diseases
;
etiology
;
Humans
;
Lupus Erythematosus, Systemic
;
blood
;
complications
;
Male
;
Middle Aged
;
Retrospective Studies
10.Incidence and clinical characteristics of engraftment syndrome after syngeneic hematopoietic stem cell transplantation in patients with hematological diseases.
Rui LOU ; Lan Ping XU ; Xiao Hui ZHANG ; Kai Yan LIU ; Yu WANG ; Chen Hua YAN ; Xiao Jun HUANG ; Yu Qian SUN
Chinese Journal of Hematology 2023;44(4):289-294
Objective: To explore the incidence and clinical characteristics of engraftment syndrome (ES) after syngeneic hematopoietic stem cell transplantation (syn-HSCT) in patients with hematological diseases. Methods: The clinical data of 21 patients who received syn-HSCT at People's Hospital of Peking University from January 1994 to May 2018 were retrospectively analyzed. Results: Seven (33.3% ) of 21 patients developed ES. The onset of ES symptoms occurred at a median of 8 (range: 5-13) days after HSCT, and the diagnosis of ES occurred at a median of 10 (range: 7-14) days after HSCT. Steroids were administered immediately after the diagnosis of ES, the median time of symptom continuance was 2 (range: 1-5) days, and all patients showed complete resolution of ES symptoms. In the multivariate analysis, patients with acute myeloid leukemia and faster neutrophil reconstitution were the risk factors for ES (HR=15.298, 95% CI 1.486-157.501, P=0.022, and HR=17.459, 95% CI 1.776-171.687, P=0.014) . Meanwhile, there was no significant difference in the overall survival and disease-free survival between patients with ES and those without ES. Conclusion: A high incidence of ES was observed in syn-HSCT recipients. Moreover, the prognosis of ES was excellent.
Humans
;
Retrospective Studies
;
Incidence
;
Graft vs Host Disease/etiology*
;
Hematopoietic Stem Cell Transplantation/adverse effects*
;
Hematologic Diseases/complications*