Harbin Medical University, No. 157 Health Road, Nangang District, Harbin, 150001, China.
Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.
Sci Rep. 2024 Aug 28;14(1):19987. doi: 10.1038/s41598-024-71082-2.
This study was conducted to identify the characteristics and risk factors for early death in critically ill acute promyelocytic leukaemia (APL) patients in the Hemato-oncology ICU (HICU). A total of 44 APL patients from 2017 to 2023 were included. The mortality among APL patients in the HICU was high (27/44, 61.36%). Compared with patients who survived, nonsurvivors had a longer prothrombin time (P = 0.002), lower fibrinogen (P = 0.022), higher white blood cell count (P = 0.004) and higher creatinine (P = 0.037) on hosipital admission. Severe bleeding was the most frequent complication (34 cases, 77.27%), which occurred either preinduction or on Day 5 (IQR 3-7.5 days) of induction. Cerebral bleeding associated with consciousness disturbance was the main reason for HICU admission (18 cases, 40.9%). The leading cause of death was fatal haemorrhage (18/34, 52.94%), which occurred either preinduction or on Day 4 (IQR 3-7 days) of induction. Another common cause of death was sepsis (8/18, 44.44%), which occurred on Day 12 (IQR 9.5-24.75 days) during induction. In conclusion, the main cause of death in APL patients treated in the HICU was primary being attributed to fatal bleeding, followed by sepsis.
本研究旨在确定重症监护病房（HICU）中急性早幼粒细胞白血病（APL）危重症患者早期死亡的特征和危险因素。共纳入 2017 年至 2023 年的 44 例 APL 患者。APL 患者在 HICU 中的死亡率很高（27/44，61.36%）。与存活患者相比，非存活患者的凝血酶原时间更长（P=0.002），纤维蛋白原更低（P=0.022），白细胞计数更高（P=0.004），入院时肌酐更高（P=0.037）。严重出血是最常见的并发症（34 例，77.27%），发生在诱导前或诱导第 5 天（IQR 3-7.5 天）。与意识障碍相关的脑出血是 HICU 入院的主要原因（18 例，40.9%）。死亡的主要原因是致命性出血（18/34，52.94%），发生在诱导前或诱导第 4 天（IQR 3-7 天）。另一个常见的死亡原因是感染性休克（8/18，44.44%），发生在诱导第 12 天（IQR 9.5-24.75 天）。总之，HICU 中 APL 患者死亡的主要原因是致命性出血，其次是感染性休克。
