Hematologic Neoplasms ; complications ; Humans ; Tuberculosis ; complications

OBJECTIVETo investigate the epidemiological characteristics and drug resistance profile of the infection in patients with hematological malignancies.

METHODSAll the microbe strains isolated from the department of hematology in Ruijin hospital between 1998 and 2002 were collected for the assessment of antimicrobial susceptibility and the results were analysed by WHONET5 software.

RESULTSOut of the 536 strains isolated in the department of hematology, 230 (42.9%) were Gram positive and 301 (56.2%) Gram negative organisms. The first 6 strains of Gram (-) microbes in frequent order were Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter cloacae, Escherichia coli, Acinetobacter Baumannii and Stenotrophomonas (xantho) maltophi. The extended spectrum beta-lactamase (ESBLs) producing rates of Escherichia coli and Klebsiella pneumoniae were 27.3% and 33.3%, respectively. Methylcillin resistant coagulase negative staphylococcus (MRCNS) was the most prevalent Gram (+) bacteria in the complicated infection patients with hematological malignancies, which accounted for 88.5%. Carbapenems were most sensitive for all of the gram negative bacteria, with a drug resistance rate of 11.4 (5.0% approximately 15.8%) of imipenem. For ESBLs strains, carbapenems and cefapime were the best choice, with the resistance rate of 46.4% approximately 94.4% and 50.0% approximately 75.9%, respectively. The drug resistance rate of Acinetobacter Baumannii was 25.0% approximately 41.3% for the third generation cephalosporin, 22.7% for the fourth generation cephalosporin and 12.7% for imipenem. Pseudomonas aeruginosa was resistant to carbapenems, with a resistance rate of 12.7% of imipenem; however, it was more sensitive to the third generation cephalosporin.

CONCLUSIONAntibiotics should be rationally administrated with more considerations to the characteristics of epidemiology and drug resistance profile of the microbes in the given department of hematology.

Bacterial Infections ; complications ; epidemiology ; microbiology ; Drug Resistance, Bacterial ; Hematologic Neoplasms ; complications ; Humans ; Microbial Sensitivity Tests

Adult ; Child ; Eosinophilia ; complications ; Female ; Hematologic Neoplasms ; complications ; Humans ; Male ; Middle Aged

OBJECTIVETo investigate the risk factors for capillary leak syndrome (CLS) in children with malignant hematologic diseases.

METHODSThirty children with hematological malignancies complicated with CLS were analyzed with multiple logistic regression analysis.

RESULTSAt the test level of 0.05, hypoxemia and septicemia were found to significantly correlate with CLS in these children, and the number of white blood cells before CLS and severe bone marrow suppression were near the test level.

CONCLUSIONHypoxemia and septicemia are risk factors for CLS in children with malignant hematologic diseases.

Capillary Leak Syndrome ; complications ; Child ; Hematologic Neoplasms ; complications ; Humans ; Hypoxia ; complications ; Leukocyte Count ; Risk Factors ; Sepsis ; complications

OBJECTIVE: To explore the risk and location of multiple malignancies in patients with hematologic malignancies who were followed up for 9 years in Jiangsu Province Hospital and to evaluate the impact of the second primary malignancy on survival of patients. METHODS: The incidence and survival of multiple malignancies in 7 921 patients with hematologic malignancies from 2009 to 2017 were analyzed retrospectively. RESULTS: A total of 180 (2.3%, 180/7 921) patients developed second malignancy, of whom 58 patients were diagnosed with hematologic malignancies as the first primary malignancy, and 98 patients developed hematologic malignancies as second primary malignancy, and the other 24 cases were diagnosed with the second malignancy within 6 months after the first primary malignancy was diagnosed, which was difined as multiple malignancies occurring simultaneously. In 180 patients, 18 cases developed two hematologic malignancies successively, and 11 patients developed more than 3 primary cancers (among them, 2 female patients were diagnosed with 4 primary cancers). Patients with lymphoma and multiple myeloma (MM) as the second primary malignancy had poorer survival than patients with lymphoma and MM as the first primary malignancy. Patients with chronic myeloid leukemia as the second primary malignancy were also associated with inferior overall survival. CONCLUSION In this study, 2.3% of hematologic malignancy patients had multiple mali-gnancies, lymphoma and MM as the second primary malignancy had poor survival.
Humans ; East Asian People ; Hematologic Neoplasms/complications* ; Lymphoma/complications* ; Multiple Myeloma/complications* ; Neoplasms, Second Primary ; Retrospective Studies ; Survival Analysis

OBJECTIVE: To investigate the clinical characteristics and prognosis of hematological malignancies superimposed patients with solid tumors. METHODS: The clinical data of 30 patients with more than two kinds of malignancy (the second is hematological malignancy) from October 2011 to October 2020 in Department of Hematology, Jiangning Hospital Affiliated to Nanjing Medical University were collected and analyzed retrospectively. The overall survival time was used as the prognostic evaluation standard, and the survival of patients were analyzed by KaplanMeier method. Logrank test and Cox regression model were used to carry out univariate and multivariate retrospective analysis on clinical and laboratory parameters of 30 patients. RESULTS: Among 30 cases, 20 were male, 10 were female, the median age of onset of the second tumor was 70 years old. The common types of the secondary hematological malignancies to solid tumors are myelodysplastic syndrome, acute myeloid leukemia, multiple myeloma. Univariate analysis showed that patients' gender, age, type of solid tumors, the onset of interval between two kinds of tumor, chromosome karyotype were not related to do with the patients' overall survival time. Type of hematologic disease, ECOG score were associated with patients' overall survival time, and the multivariate analysis showed that the type of hematologic disease and ECOG score were independent risk factors for patients with poor prognosis. CONCLUSION Patients superimposed with solid tumors complicated with myelodysplastic syndrome or acute leukemia and ECOG score ≥3 have poor prognosis and shorter overall survival time, which are independent risk factors influencing the prognosis. Bone marrow injury, immune dysfunction and genetic susceptibility after chemoradiotherapy may be the main causes of these diseases.
Aged ; Female ; Hematologic Neoplasms/complications* ; Humans ; Leukemia, Myeloid, Acute/complications* ; Male ; Myelodysplastic Syndromes/complications* ; Prognosis ; Retrospective Studies

BACKGROUND: Invasive pulmonary aspergillosis, a frequent fungal infection in immunocompromised patients, is known to have a poor prognosis despite the use of antifungal therapy in leukemic patients. We studied the outcome of surgical resection of invasive pulmonary aspergillosis where bleeding tendency, localized recurrence of infection, and incidence could be reduced. MATERIAL AND METHOD: We retrospectively reviewed 14 patients with a hematological malignancy where invasive pulmonary aspergillosis was diagnosed during the 10 years between 1998 and 2007. From the medical records, we reviewed the type and treatment of the hematological malignancy, including the diagnostic methods of invasive pulmonary aspergillosis, the preoperative hematological conditions and their management, and the surgical methods and records. We also analyzed the development of postoperative complications and patient mortality, the recurrence of postoperative invasive pulmonary aspergillosis, and if the patients had a bone marrow transplant. RESULT: Fourteen patients with invasive pulmonary aspergillosis and a hematological malignancy underwent a pulmonary lobectomy. One patient had a complication of bronchopleural fistula, but there were no other serious complications such as bleeding or wound infection, and none of the patients died postoperatively. CONCLUSION: We have shown that pulmonary lobectomy is a safe and effective therapy for invasive pulmonary aspergillosis in patients with hematological malignancies that allow further treatment of the hematological malignancy.
Bone Marrow ; Fistula ; Hematologic Diseases ; Hematologic Neoplasms* ; Hemorrhage ; Humans ; Immunocompromised Host ; Incidence ; Invasive Pulmonary Aspergillosis* ; Medical Records ; Mortality ; Postoperative Complications ; Prognosis ; Pulmonary Aspergillosis ; Recurrence ; Retrospective Studies ; Wound Infection

Adolescent ; Child ; Child, Preschool ; Female ; Hematologic Neoplasms ; complications ; Humans ; Infant ; Lung Diseases, Fungal ; drug therapy ; etiology ; Male

OBJECTIVE: To analyze the clinical characteristics of patients with hematological tumor or disease before and after reversible posterior leukoen-cephalopathy syndrome (RPLS). METHODS: Five patients were both from Peking University First Hospital Pediatric Hematology-oncology Department in the period from March 2012 to March 2017. The gender, age, BMI, underlying diseases, with or without renal damage, hypertension family history, clinical manifestations of convulsions, hemoglobin, and blood pressure, serum sodium levels before and after convulsion, and other data of the children with RPLS were retrospectively analyzed. In the meantime, we followed up the five patients for 6 months to 66 months, kept a watchful eye on their original condition and the recovery of symptoms and signs of the nervous system. The relevant literature was reviewed. RESULTS: All of the subjects were females in school-age or pre-school age. The underlying diseases were malignant tumor associated with renal involvement or on one side of nephrectomy in 4 of these subjects, while the other one was refractory autoimmune hemolytic anemia. All of the subjects suffered from mild or moderate anemia. The day before RPLS occurred they received chemotherapy made up with cyclophosphamide, vincristine, and actinomycin-D, or the therapy with cyclosporin A and glucocorticoid. The clinical manifestations were afebrile convulsion after getting up in the mooring or in the afternoon. We observed elevation of blood pressure and cutting down of serum sodium compared with themselves. All of the cases recovered soon after management with diazepam, furosemide and amlodipine besylate. Four of them had a good outcomes and did not remain any sequela, while only one girl became childish in emotion and behavior, and then returned gradually to normal two years later. However, by long-term follow-up, the elevation of blood pressure was mainly reviewed in literature. CONCLUSION The patients attacked by RPLS, with hematology or oncology cases, could have the underlying disease of renal damage and anemia. Blood pressure elevation and serum sodium falling down at the same time may play an important role during the occurrence of RPLS. Remaining stable of blood pressure and electrolyte level together will possibly reduce or mitigate RPLS.
Blood Pressure ; Child ; Child, Preschool ; Female ; Hematologic Neoplasms/complications* ; Humans ; Hypertension/etiology* ; Posterior Leukoencephalopathy Syndrome/therapy* ; Retrospective Studies ; Seizures/etiology*

OBJECTIVES: To explore the value of metagenomic next-generation sequencing (mNGS) in the pathogen identification in children with hematological malignancies complicated with infections. METHODS: A retrospective analysis was conducted on clinical data and pathogenic test results of 43 children with hematological malignancies who underwent microbial culture and mNGS due to infections in the Third Xiangya Hospital of Central South University between June 2020 and July 2022. Differences in detection rates and characteristics of pathogenic microorganisms detected by mNGS and microbial culture were compared. RESULTS: A total of 54 specimens were examined, and the overall detection rate of pathogen by mNGS (80%, 43/54) was significantly higher than that by microbial culture (30%, 16/54) (P<0.001). The most commonly detected infection type by mNGS was viral infection, followed by fungal infection combined viral infection, while that by microbial culture was bacterial infection, followed by fungal infection. The detection rate of fungi by mNGS (33%, 18/54) was higher than that by microbial culture (6%, 3/54) (P<0.001). The detection rate of two or more pathogenic microorganisms by mNGS was higher at 48% compared to microbial culture at 9% (P<0.05). The detection rate of two or more types of pathogenic microorganisms by mNGS was also significantly higher at 33% compared to microbial culture at 2% (P<0.05). The most commonly detected bacteria and fungi by mNGS were Pseudomonas aeruginosa and Candida tropicalis, respectively, in peripheral blood, while Streptococcus pneumoniae and Pneumocystis jirovecii were most commonly detected in bronchoalveolar lavage fluid. Treatment adjustments based on mNGS results were beneficial for 35% (15/43) of the cases. CONCLUSIONS mNGS has a higher detection rate than microbial culture and has obvious advantages in diagnosing mixed and fungal infections, making it a useful supplementary diagnostic method to microbial culture.
Humans ; Child ; Retrospective Studies ; Hematologic Neoplasms/complications* ; High-Throughput Nucleotide Sequencing ; Bronchoalveolar Lavage Fluid ; Hospitals ; Sensitivity and Specificity