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利用基于聚合酶链反应的诊断技术在霍奇金淋巴瘤患者中检测肺炎的发生率、临床表现和结局。

Incidence, clinical presentation, and outcomes of pneumonia when utilizing Polymerase Chain Reaction-based diagnosis in patients with Hodgkin lymphoma.

机构信息

Department of Pharmacy, Mayo Clinic, Rochester, MN, USA.

Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

出版信息

Leuk Lymphoma. 2020 Nov;61(11):2622-2629. doi: 10.1080/10428194.2020.1786561. Epub 2020 Jul 5.

Abstract

A Polymerase Chain Reaction-based diagnosis of Pneumonia (PCP) and the need for anti- prophylaxis in Hodgkin lymphoma patients receiving chemotherapy requires further investigation. This retrospective, single-center, study evaluated 506 consecutive adult patients diagnosed with Hodgkin lymphoma receiving chemotherapy between January 2006 and August 2018. The cumulative incidence of PCP 1 year after start of chemotherapy was 6.2% (95% CI 3.8-8.5%). Mortality 30 days from PCP diagnosis was 8% ( = 2) with one death attributable to PCP. Bleomycin-containing combination chemotherapy regimen was not significantly associated with a higher risk for PCP when compared to other regimens (HR = 1.59, 95% CI 0.55-4.62  = 0.40). Anti- prophylaxis was not significantly associated with a decreased incidence of PCP (HR = 0.51, 95% CI 0.15-1.71,  = 0.28). As the overall incidence is above the commonly accepted 3.5% threshold, clinicians should consider the potential value of prophylaxis. The utility of universal vs. targeted anti- prophylaxis requires prospective, randomized investigation.

摘要

基于聚合酶链反应的肺炎(PCP)诊断和接受化疗的霍奇金淋巴瘤患者抗预防的需求需要进一步研究。这项回顾性、单中心研究评估了 2006 年 1 月至 2018 年 8 月期间接受化疗的 506 例连续确诊的霍奇金淋巴瘤成年患者。化疗开始后 1 年 PCP 的累积发生率为 6.2%(95%CI3.8-8.5%)。PCP 诊断后 30 天的死亡率为 8%( = 2),其中 1 例死亡归因于 PCP。与其他方案相比,含博来霉素的联合化疗方案与 PCP 的高风险无显著相关性(HR=1.59,95%CI0.55-4.62, = 0.40)。抗预防与 PCP 发生率降低无显著相关性(HR=0.51,95%CI0.15-1.71, = 0.28)。由于总发生率高于普遍接受的 3.5%阈值,临床医生应考虑预防的潜在价值。普遍和有针对性的抗预防的效用需要前瞻性、随机研究。

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