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利奈唑胺致急性髓系白血病患者血小板减少症:一项匹配病例对照研究。

Linezolid-induced thrombocytopenia in patients with acute myeloid leukemia: a matched case-control study.

机构信息

Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou, 310006, Zhejiang, People's Republic of China.

Department of Critical Care Medicine, Hangzhou First People's Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China.

出版信息

Clin Transl Oncol. 2022 Mar;24(3):540-545. doi: 10.1007/s12094-021-02711-9. Epub 2021 Oct 29.

Abstract

PURPOSE

After the wide use of linezolid (LZD), numerous reports of uncontrolled studies have suggested that LZD is associated with high rates of thrombocytopenia. We conducted this matched case-control study to identify the risk factors for LZD-induced thrombocytopenia in patients with acute myeloid leukemia (AML) during the period of myelosuppression.

METHODS

We retrospectively retrieved laboratory and clinical data from the medical records of 180 Chinese with AML. Among them, 60 received ≥ 72 h of therapy with LZD during myelosuppression. The remaining patients who did not receive LZD therapy were matched individually in a ratio of 1:2 according to the basic characteristics of the LZD group.

RESULTS

We found that in the LZD group, age, history of liver or kidney disease, the baseline level of bilirubin, and creatinine clearance rate (CCR) did not affect the recovery time of platelets. Patients who received LZD for more than 7 days during the period of myelosuppression had a significantly longer time of platelet recovery and platelet count increase.

CONCLUSION

The use of LZD > 7 days during the course of myelosuppression and the low level of albumin can prolong the time required for platelet count increase and recovery. Further study is needed to assess the potential adverse effects of LZD in larger AML patient populations.

摘要

目的

利奈唑胺(LZD)广泛应用后,大量非对照研究报告提示 LZD 与血小板减少症发生率高有关。我们进行了这项匹配病例对照研究,以确定在骨髓抑制期间接受 LZD 治疗的急性髓系白血病(AML)患者发生 LZD 诱导性血小板减少症的危险因素。

方法

我们回顾性地从 180 例中国 AML 患者的病历中检索了实验室和临床数据。其中 60 例在骨髓抑制期间接受了≥72 小时的 LZD 治疗。其余未接受 LZD 治疗的患者根据 LZD 组的基本特征,按 1:2 的比例进行个体匹配。

结果

我们发现,在 LZD 组中,年龄、肝或肾病病史、胆红素基线水平和肌酐清除率(CCR)并不影响血小板的恢复时间。在骨髓抑制期间接受 LZD 治疗超过 7 天的患者血小板恢复和血小板计数增加的时间明显延长。

结论

骨髓抑制期间 LZD 使用超过 7 天和白蛋白水平低可延长血小板计数增加和恢复所需的时间。需要进一步研究来评估 LZD 在更大的 AML 患者人群中的潜在不良影响。

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