Yin Xuejiao, Hu Xuelian, Tong Hongyan, You Liangshun
Department of Hematology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Zhejiang Province Key Laboratory of Hematology Oncology Diagnosis and Treatment, Hangzhou, China.
Ther Adv Chronic Dis. 2023 Jun 21;14:20406223231173891. doi: 10.1177/20406223231173891. eCollection 2023.
Infection is the most important cause of non-relapse mortality in hematologic malignancy patients, leading to increased costs and prolonged hospitalization times. However, comprehensive and comparable reports on infection-specific mortality (ISM) trends in hematologic malignancy patients are lacking.
We aimed to provide updated ISM trends and factors associated with ISM among hematologic malignancy patients.
This is a retrospective study.
Patients diagnosed with the five most common hematologic malignancies from 1983 to 2016 from the Surveillance, Epidemiology, and End Results database were included. Joinpoint regression was used to analyze mortality trends.
ISM decreased beginning in 1983, 1988, and 1994, with yearly decreases of -2.1% for acute leukemia (AL), -1.3% for Hodgkin lymphoma (HL), and -14.3% for non-Hodgkin lymphoma (NHL). In contrast, ISM in patients with chronic leukemia (CL) and multiple myeloma (MM) increased dramatically beginning in 2000, with yearly increases of 2.8% and 3.3%, respectively. ISM rates were higher in males than in females across all hematologic malignancy subtypes. The mortality trends significantly differed according to race, age, sex, and stage, which could help in further etiological investigations. Moreover, male sex, older age at diagnosis, black race, and unmarried status were poor prognostic factors for ISM across all hematologic malignancy subtypes.
A promising downward trend in ISM in recent years occurred in patients with AL, HL, and NHL; however, ISM increased dramatically in patients with CL and MM. Our data suggest that risk assessment and careful infection monitoring are recommended for hematologic malignancy patients, particularly those with CL and MM.
感染是血液系统恶性肿瘤患者非复发死亡率的最重要原因，导致成本增加和住院时间延长。然而，缺乏关于血液系统恶性肿瘤患者感染特异性死亡率（ISM）趋势的全面且可比的报告。
我们旨在提供血液系统恶性肿瘤患者最新的ISM趋势以及与ISM相关的因素。
这是一项回顾性研究。
纳入了1983年至2016年来自监测、流行病学和最终结果数据库中诊断为五种最常见血液系统恶性肿瘤的患者。采用Joinpoint回归分析死亡率趋势。
ISM在1983年、1988年和1994年开始下降，急性白血病（AL）每年下降-2.1%，霍奇金淋巴瘤（HL）每年下降-1.3%，非霍奇金淋巴瘤（NHL）每年下降-14.3%。相比之下，慢性白血病（CL）和多发性骨髓瘤（MM）患者的ISM从2000年开始显著增加，每年分别增加2.8%和3.3%。在所有血液系统恶性肿瘤亚型中，男性的ISM率高于女性。死亡率趋势根据种族、年龄、性别和分期有显著差异，这有助于进一步的病因学研究。此外，男性、诊断时年龄较大、黑人种族和未婚状态是所有血液系统恶性肿瘤亚型中ISM的不良预后因素。
近年来，AL、HL和NHL患者的ISM呈有希望的下降趋势；然而，CL和MM患者的ISM显著增加。我们的数据表明，建议对血液系统恶性肿瘤患者，特别是CL和MM患者进行风险评估并仔细监测感染情况。
