Tominaga Ryutaro, Fujiwara Shin-Ichiro, Honda Seina, Yokoyama Daizo, Noguchi Atsuto, Furuki Shuka, Koyama Shunsuke, Murahashi Rui, Nakashima Hirotomo, Hyodo Kazuki, Kawaguchi Shin-Ichiro, Toda Yumiko, Umino Kento, Minakata Daisuke, Ashizawa Masahiro, Yamamoto Chihiro, Hatano Kaoru, Sato Kazuya, Ohmine Ken, Kanda Yoshinobu
Division of Hematology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Division of Cell Transplantation and Transfusion, Jichi Medical University, Shimotsuke, Tochigi, Japan.
Int J Hematol. 2025 Sep 18. doi: 10.1007/s12185-025-04070-5.
This study explored the relationship between body temperature (BT) and heart rate (HR) data during acute myeloid leukemia (AML) treatment, using relative bradycardia (RB) as an index. RB trends were also assessed in confirmed infections and during intensive chemotherapy. Data from AML patients who received induction therapy (anthracycline and cytarabine) at Jichi Medical University Hospital between May 2015 and December 2023 were analyzed. A total of 1000 febrile events (axillary temperature ≥ 37.8 °C) in 97 patients were included. Multivariate analysis showed an HR increase of 6.57 bpm (95% CI 4.44-8.70) per 1 °C rise in BT. RB, defined as BT ≥ 37.8 °C with HR < 90 bpm, was observed in 630 events (63.0%). RB was more likely with age ≥ 44 years, hemoglobin ≥ 6.5 g/dL, and reduced-intensity regimens. In contrast, BT ≥ 38.6 °C, diastolic BP ≥ 70 mmHg, oxygen therapy, CRP ≥ 7.13 mg/dL, and incomplete hematologic recovery decreased the likelihood of RB. In addition, RB was significantly associated with documented infection (OR = 2.32, 95% CI 1.17-4.61, p = 0.016). RB frequently occurred during AML induction therapy, and may serve as an indicator of infection.
本研究以相对心动过缓（RB）为指标，探讨急性髓系白血病（AML）治疗期间体温（BT）与心率（HR）数据之间的关系。还对确诊感染患者和强化化疗期间的RB趋势进行了评估。分析了2015年5月至2023年12月期间在秩父市立医科大学医院接受诱导治疗（蒽环类药物和阿糖胞苷）的AML患者的数据。共纳入97例患者的1000次发热事件（腋窝温度≥37.8°C）。多变量分析显示，BT每升高1°C，HR增加6.57次/分钟（95%CI 4.44-8.70）。在630次事件（63.0%）中观察到RB，定义为BT≥37.8°C且HR<90次/分钟。年龄≥44岁、血红蛋白≥6.5g/dL和低强度治疗方案时更易出现RB。相比之下，BT≥38.6°C、舒张压≥70mmHg、氧疗、CRP≥7.13mg/dL和血液学未完全恢复会降低出现RB的可能性。此外，RB与记录在案的感染显著相关（OR=2.32，95%CI 1.17-4.61，p=0.016）。RB在AML诱导治疗期间频繁出现，可能作为感染的一个指标。
