J Korean Med Sci.  2005 Feb;20(1):31-35. 10.3346/jkms.2005.20.1.31.

Prognostic Factors Influencing Infection-related Mortality in Patients with Acute Leukemia in Korea

• Yoo JH
• Choi SM
• Lee DG
• Choi JH
• Shin WS
• Min WS
• Kim CC

• KMID: 1781720
• DOI: http://doi.org/10.3346/jkms.2005.20.1.31

Abstract

We retrospectively reviewed the medical records of 284 patients with neutropenic fever following chemotherapy for acute leukemia at the Catholic Hematopoietic Stem Cell Transplantation Center from January 1998 to December 1999, to identify prognostic factors for infection related mortality. Twenty-eight patients died of infections. There was no difference in median age, gender ratio, or underlying disease between the dying and surviving groups. Bacteria were the main pathogens following chemotherapy, and Gram positive organisms predominated in the dying group. Pneumonia and sepsis were the main causes of death. There were 72 cases of invasive fungal infection and their mortality was 27.8%. Invasive fungal infection and previous history of fungal infection were independent prognostic factors for outcome. Recovery from neutropenia was the significant protective factor for mortality. In conclusion, the prognostic factors identified in this study could be useful for deciding on more intensive treatment for those patients at greater risk of death. To our knowledge, this is the first Korean study delineating prognostic factors in acute leukemic patients with infectious complications.

Keyword

Leukemia; Infection; Prognosis, Neutropenia; Mycoses; Fungal Infection

MeSH Terms

Adolescent
Adult
Aged
Bacterial Infections/complications/*mortality
Cause of Death
Female
Humans
Korea
Leukemia
Leukemia, Lymphocytic, Acute/complications/*microbiology/*mortality
Leukemia, Myelocytic, Acute/complications/*microbiology/*mortality
Male
Middle Aged
Morbidity
Multivariate Analysis
Mycoses/complications/mortality
Neutropenia
Pneumonia/complications/mortality
Prognosis
Retrospective Studies
Sepsis/complications/mortality
Survival Rate

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