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Titolo:
Invasive aspergillosis in neutropenic patients: rapid neutrophil recovery is a risk factor for severe pulmonary complications
Autore:
Todeschini, G; Murari, C; Bonesi, R; Pizzolo, G; Verlato, G; Tecchio, C; Meneghini, V; Franchini, M; Giuffrida, C; Perona, G; Bellavite, P;
Indirizzi:
Univ-37134a, Policlin Borgo Roma, Sch Med, Dept Haematol,Cattedra Ematol, I Univ Verona Verona Italy I-37134 h Med, Dept Haematol,Cattedra Ematol, I Univ Verona, Sch Med, Dept Clin Chem, I-37134 Verona, Italy Univ Verona Verona Italy I-37134 , Dept Clin Chem, I-37134 Verona, Italy Univ Verona, Sch Med, Dept Med Stat, I-37134 Verona, Italy Univ Verona Verona Italy I-37134 d, Dept Med Stat, I-37134 Verona, Italy
Titolo Testata:
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
fascicolo: 5, volume: 29, anno: 1999,
pagine: 453 - 457
SICI:
0014-2972(199905)29:5<453:IAINPR>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
FATAL HEMOPTYSIS; AMPHOTERICIN-B; ACUTE-LEUKEMIA; CORTICOSTEROID-THERAPY; GM-CSF; INHIBITOR; DEFENSE;
Keywords:
haemoptysis; invasive aspergillosis; neutropenia; neutrophil recovery; pneumothorax;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Todeschini, G Univ-37134a, Policlin Borgo Roma, Sch Med, Dept Haematol,Cattedra Ematol, I Univ Verona Verona Italy I-37134 ematol,Cattedra Ematol, I
Citazione:
G. Todeschini et al., "Invasive aspergillosis in neutropenic patients: rapid neutrophil recovery is a risk factor for severe pulmonary complications", EUR J CL IN, 29(5), 1999, pp. 453-457

Abstract

Background In invasive aspergillosis, the duration of neutropenia is an accepted risk factor, and recovery from neutropenia is generally associated with a favourable outcome. However, the rapidity of granulocyte recovery mayrarely be associated with adverse sequelae. The purpose of this study was to define the relationship between neutrophil (polymorphonuclear, PMN) recovery after chemotherapy-induced bone marrow aplasia and the occurrence of severe pulmonary complications (haemoptysis, pneumothorax and death) in patients with haematological malignancies who developed invasive fungal pneumonias. Methods Twenty consecutive patients were retrospectively studied; eight ofthem had developed pulmonary events between 5 and 11 days after neutrophilrecovery that followed deep neutropenia (PMN < 100 mu L-1). Results Five patients had haemoptysis (one of these also had pneumothorax)and three had pneumothorax. According to the multiplicative logistic model, the odds of occurrence of a pulmonary event increased significantly with increasing PMN count on the fifth day (P < 0.001). Five of the eight patients who had pulmonary complications died. Also, the risk of death was largerin the presence of rapid neutrophil recovery, although the difference was not statistically significant (P = 0.111). Analysis of clinical and laboratory data showed that the risk of pulmonary complications significantly increased when the neutrophil concentration was >4500 mu L-1 on day 5 after deep granulocyte neutropenia (PMN < 100 mu L-1). There was no correlation between pulmonary complications, dosage of amphotericin B and deaths. Conclusion The occurrence of life-threatening complications in patients with invasive fungal pneumonia is closely related to rapid PMN recovery.

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Documento generato il 25/09/20 alle ore 16:19:39