INFECTION FEATURES OF ACUTE LEUKEMIA PATIENTS DURING INDUCTION CHEMOTHERAPY: A RETROSPECTIVE ANALYSIS OF 203 CASES

Abstract

Infection is a major complication of chemotherapy for Acute Leukemia (AL). Two hundred and three patients with newly diagnosed AL were recruited in this study. By analyzing infection incidence (82.8%, 168/203), infection-related mortality (7.1%, 12/168), clinical features, and risk factors, as well as the correlation with efficacy for the patients during induction chemotherapy, we aimed to understand the significance of infection in patients with them, thereby guiding clinical treatment. All of the patients, 168 cases suffered from infection; among of them, there were clear sites of infection accounted for 94.6% (159/168), and the most infection sites were lungs, gastrointestinal tract, and oral cavity. 213 of pathogens were detected, including gram-negative bacilli (39.0%, 83/213), Gram-positive cocci (34.3%, 73/213), fungi (23.5%, 50/213), and virus (3.3%, 7/213). Diagnosis/clinical diagnosis of the patients with invasive fungal disease accounted for 24.6%, and the main pathogen was Candida. Multivariate analysis of the risk factor of infection showed that was neutropenia (P < 0.001, OR = 14.37, 95% CI 2.576 - 116.518); however, infection did not affect the rate of CR/CRi ( χ² = 2.564, P = 0.109).Conclusion: During the first induction therapy for newly diagnosed AL patients, the rate of infection and fungal infection was high, Lung is the most common site of infection, Gram-negative bacteria is more common, agranulocytosis increase the chance of infection, it does not affect the complete remission rate.