Yilmaz Fatma, Saglam Bugra, Gorduk Ufuk, Kalan Ugur, Ozturk Hacer Berna Afacan, Gunes Ahmet Kursad, Albayrak Murat
Etlik City Hospital, Department of Hematology, Ankara, Turkey.
Medicalpoint Hospital, Department of Hematology, Gaziantep, Turkey.
Mediterr J Hematol Infect Dis. 2024 Sep 1;16(1):e2024071. doi: 10.4084/MJHID.2024.071. eCollection 2024.
Patients with leukaemia are exposed to infections as long as they are neutropenic. During this period, anorectal pathologies are among the common foci of infection with high mortality. In this study, we aim to investigate the factors that may have a predictive effect on early diagnosis and rapid intervention in perianal complications occurring in neutropenic patients diagnosed with leukaemia.
A total of 90 patients with acute leukaemia, including 45 patients with anorectal pathology and 45 patients without anorectal pathology, were analysed. Demographics, blood group, BMI, haemogram and biochemical parameters at the time of diagnosis, and types of perianal pathology were recorded.
In the group of patients with anorectal pathology, WBC, lymphocytes, monocytes, and LDH were significantly (p<0.05) higher, and platelets, MPV, and PCT were significantly (p<0.05) lower. The multivariate model showed significant-independent (p<0.05) efficacy of WBC and MPV values in differentiating patients with and without anorectal pathology. A significant efficacy was observed at the WBC cut-off of 17000 [area under the curve 0.656 (0.542-0.770)] and the MPV cut-off of 10 [area under the curve 0.667 (0.554-0.780)] in differentiating patients with and without anorectal pathology.
Anorectal pathologies are common foci of infection in patients with acute leukaemia. Having predictive parameters that may help for early intervention will help the clinician. This is the first study in the literature to compare a control group with a group with anorectal pathologies in leukaemia patients providing a cut-off for WBC.
白血病患者在中性粒细胞减少期间易发生感染。在此期间，肛肠疾病是常见的感染病灶，死亡率较高。在本研究中，我们旨在调查可能对诊断为白血病的中性粒细胞减少患者发生的肛周并发症进行早期诊断和快速干预有预测作用的因素。
共分析了90例急性白血病患者，其中45例有肛肠疾病，45例无肛肠疾病。记录了人口统计学资料、血型、体重指数、诊断时的血常规和生化参数以及肛周病理类型。
在有肛肠疾病的患者组中，白细胞、淋巴细胞、单核细胞和乳酸脱氢酶显著（p<0.05）升高，而血小板、平均血小板体积和血小板压积显著（p<0.05）降低。多变量模型显示白细胞和平均血小板体积值在区分有无肛肠疾病的患者方面具有显著独立（p<0.05）疗效。在区分有无肛肠疾病的患者时，白细胞临界值为17000[曲线下面积0.656（0.542-0.770）]和平均血小板体积临界值为10[曲线下面积0.667（0.554-0.780）]时观察到显著疗效。
肛肠疾病是急性白血病患者常见的感染病灶。具有有助于早期干预的预测参数将对临床医生有所帮助。这是文献中第一项在白血病患者中将对照组与有肛肠疾病的组进行比较并提供白细胞临界值的研究。
