间质性肺炎对血液病患者生存的影响及危险因素分析。
Impact of interstitial pneumonia on the survival and risk factors analysis of patients with hematological malignancy.
机构信息
Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu, Taipei 114, Taiwan.
出版信息
Biomed Res Int. 2013;2013:185362. doi: 10.1155/2013/185362. Epub 2013 Sep 4.
BACKGROUND
The emergence of interstitial pneumonia (IP) in patients with hematological malignancy (HM) is becoming a challenging scenario in current practice. However, detailed characterization and investigation of outcomes and risk factors on survival have not been addressed.
METHODS
We conducted a retrospective study of 42,584 cancer patients covering the period between 1996 and 2008 using the institutional cancer registry system. Among 816 HM patients, 61 patients with IP were recognized. The clinical features, laboratory results, and histological types were studied to determine the impact of IP on survival and identify the profile of prognostic factors.
RESULTS
HM patients with IP showed a significant worse survival than those without IP in the 5-year overall survival (P = 0.027). The overall survival showed no significant difference between infectious pneumonia and noninfectious interstitial pneumonia (IIP versus nIIP) (P = 0.323). In a multivariate Cox regression model, leukocyte and platelet count were associated with increased risk of death.
CONCLUSIONS
The occurrence of IP in HM patients is associated with increased mortality. Of interest, nIIP is a prognostic indicator in patients with lymphoma but not in patients with leukemia. However, aggressive management of IP in patients with HM is strongly advised, and further prospective survey is warranted.
背景
间质性肺炎（IP）在血液恶性肿瘤（HM）患者中的出现是当前实践中的一个具有挑战性的情况。然而，尚未详细描述结局和生存风险因素的特征和调查。
方法
我们使用机构癌症登记系统对 1996 年至 2008 年间的 42584 名癌症患者进行了回顾性研究。在 816 名 HM 患者中，识别出 61 名患有 IP 的患者。研究了临床特征、实验室结果和组织学类型，以确定 IP 对生存的影响，并确定预后因素的特征。
结果
HM 患者中出现 IP 与无 IP 的患者相比，5 年总生存率显著更差（P=0.027）。在总生存方面，感染性肺炎和非感染性间质性肺炎（IIP 与 nIIP）之间无显著差异（P=0.323）。在多变量 Cox 回归模型中，白细胞和血小板计数与死亡风险增加相关。
结论
HM 患者中发生 IP 与死亡率增加相关。有趣的是，nIIP 是淋巴瘤患者的预后指标，但不是白血病患者的预后指标。然而，强烈建议对 HM 患者的 IP 进行积极治疗，需要进一步进行前瞻性调查。
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