骨髓增生异常综合征患者感染危险因素及预防

龚婧晔, 肖志坚. 骨髓增生异常综合征患者感染危险因素及预防[J]. 临床血液学杂志, 2021, 34(1): 65-70. doi: 10.13201/j.issn.1004-2806.2021.01.015
引用本文: 龚婧晔, 肖志坚. 骨髓增生异常综合征患者感染危险因素及预防[J]. 临床血液学杂志, 2021, 34(1): 65-70. doi: 10.13201/j.issn.1004-2806.2021.01.015
GONG Jingye, XIAO Zhijian. Risk factors and prophylaxis of infections in patients with myelodysplastic syndromes[J]. J Clin Hematol, 2021, 34(1): 65-70. doi: 10.13201/j.issn.1004-2806.2021.01.015
Citation: GONG Jingye, XIAO Zhijian. Risk factors and prophylaxis of infections in patients with myelodysplastic syndromes[J]. J Clin Hematol, 2021, 34(1): 65-70. doi: 10.13201/j.issn.1004-2806.2021.01.015

骨髓增生异常综合征患者感染危险因素及预防

详细信息
    通讯作者: 肖志坚,E-mail:zjxiao@ihcams.ac.cn
  • 中图分类号: R733

Risk factors and prophylaxis of infections in patients with myelodysplastic syndromes

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  • 骨髓增生异常综合征(myelodysplastic syndromes,MDS)是一组起源于造血干细胞的异质性恶性髓系克隆性疾病[1]。由于疾病本身及治疗等因素,MDS患者在病程中较易发生感染,感染是MDS患者死亡的主要原因[2-3]。因此,评估患者感染风险从而及早采取相应监测、预防措施,可进一步改善MDS患者生存质量,延长总体生存时间(overall survival,OS)[4]。本文就MDS患者的感染危险因素及预防做一综述。
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  • [1]

    肖志坚.骨髓增生异常综合征的精准诊断与治疗:现况与问题[J].临床血液学杂志,2017,30(5):339-341.

    [2]

    Dayyani F,Conley AP,Strom SS,et al.Cause of death in patients with lower-risk myelodysplastic syndrome[J].Cancer,2010,116(9):2174-2179.

    [3]

    Nachtkamp K,Stark R,Strupp C,et al.Causes of death in 2877 patients with myelodysplastic syndromes[J].Ann Hematol,2016,95(6):937-944.

    [4]

    肖志坚.骨髓增生异常综合征肖志坚2018观点[M].北京:科学技术文献出版社,2018:35-35.

    [5]

    Neukirchen J,Nachtkamp K,Schemenau J,et al.Change of prognosis of patients with myelodysplastic syndromes during the last 30 years[J].Leuk Res,2015,39(7):679-683.

    [6]

    Sullivan LR,Sekeres MA,Shrestha NK,et al.Epidemiology and risk factors for infections in myelodysplastic syndromes[J].Transpl Infect Dis,2013,15(6):652-657.

    [7]

    Fianchi L,Leone G,Posteraro B,et al.Impaired bactericidal and fungicidal activities of neutrophils in patients with myelodysplastic syndrome[J].Leuk Res,2012,36(3):331-333.

    [8]

    Toma A,Fenaux P,Dreyfus F,et al.Infections in myelodysplastic syndromes[J].Haematologica,2012,97(10):1459-1470.

    [9]

    Greenberg PL,Tuechler H,Schanz J,et al.Revised international prognostic scoring system for myelodysplastic syndromes[J].Blood,2012,120:2454-2465.

    [10]

    Merkel D,Filanovsky K,Gafter-Gvili A,et al.Predicting infections in high-risk patients with myelodysplastic syndrome/acute myeloid leukemia treated with azacitidine:a retrospective multicenter study[J].Am J Hematol,2013,88(2):130-134.

    [11]

    Ofran Y,Filanovsky K,Gafter-Gvili A,et al.Higher infection rate after 7-compared with 5-day cycle of azacitidine in patients with higher-risk myelodysplastic syndrome[J].Clin Lymphoma Myeloma Leuk,2015,15(6):e95-e99.

    [12]

    Lorenzana N,Avila LF,Alonso S,et al.The impact of antimicrobial prophylaxis in morbidity and infections during azacitidine treatment[J].Ann Hematol,2017,96(11):1833-1840.

    [13]

    Della Porta MG,Malcovati L,Strupp C,et al.Risk stratification based on both disease status and extra-hematologic comorbidities in patients with myelodysplastic syndrome[J].Haematologica,2011,96(3):441-449.

    [14]

    Starkman R,Alibhai S,Wells RA,et al.An MDS-specific frailty index based on cumulative deficits adds independent prognostic information to clinical prognostic scoring[J].Leukemia,2020,34(5):1394-1406.

    [15]

    Bullen JJ,Rogers HJ,Spalding PB,et al.Natural resistance,iron and infection:a challenge for clinical medicine[J].J Med Microbiol,2006,55(Pt 3):251-258.

    [16]

    Smith BD,Mahmoud D,Dacosta-Byfield S,et al.Health care utilization and risk of infection and bleeding among patients with myelodysplastic syndromes with/without transfusions,and with/without active therapy[J].Leuk Lymphoma,2014,55(5):1119-1125.

    [17]

    Kontoyiannis DP,Chamilos G,Lewis RE,et al.Increased bone marrow iron stores is an independent risk factor for invasive aspergillosis in patients with high-risk hematologic malignancies and recipients of allogeneic hematopoietic stem cell transplantation[J].Cancer,2007,110(6):1303-1306.

    [18]

    Sloand EM,Wu CO,Greenberg P,et al.Factors affecting response and survival in patients with myelodysplasia treated with immunosuppressive therapy[J].J Clin Oncol,2008,26(15):2505-2511.

    [19]

    Komrokji RS,Mailloux AW,Chen DT,et al.A phase II multicenter rabbit anti-thymocyte globulin trial in patients with myelodysplastic syndromes identifying a novel model for response prediction[J].Haematologica,2014,99(7):1176-1183.

    [20]

    Passweg JR,Giagounidis AA,Simcock M,et al.Immunosuppressive therapy for patients with myelodysplastic syndrome:a prospective randomized multicenter phase III trial comparing antithymocyte globulin plus cyclosporine with best supportive care--SAKK 33/99[J].J Clin Oncol,2011,29(3):303-309.

    [21]

    List A,Dewald G,Bennett J,et al.Lenalidomide in the myelodysplastic syndrome with chromosome 5q deletion[J].N Engl J Med,2006,355(14):1456-1465.

    [22]

    Le Bras F,Sebert M,Kelaidi C,et al.Treatment by Lenalidomide in lower risk myelodysplastic syndrome with 5q deletion--the GFM experience[J].Leuk Res,2011,35(11):1444-1448.

    [23]

    Fenaux P,Giagounidis A,Selleslag D,et al.A randomized phase 3 study of lenalidomide versus placebo in RBC transfusion-dependent patients with Low-/Intermediate-1-risk myelodysplastic syndromes with del5q[J].Blood,2011,118(14):3765-3776.

    [24]

    Almeida A,Fenaux P,Garcia-Manero G,et al.Safety profile of lenalidomide in patients with lower-risk myelodysplastic syndromes without del(5q):results of a phase 3 trial[J].Leuk Lymphoma,2018,59(9):2135-2143.

    [25]

    Fenaux P,Mufti GJ,Hellstrom-Lindberg E,et al.Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes:a randomised,open-label,phase III study[J].Lancet Oncol,2009,10(3):223-232.

    [26]

    Trubiano JA,Dickinson M,Thursky KA,et al.Incidence,etiology and timing of infections following azacitidine therapy for myelodysplastic syndromes[J].Leuk Lymphoma,2017,58(10):2379-2386.

    [27]

    Schuck A,Goette MC,Neukirchen J,et al.A retrospective study evaluating the impact of infectious complications during azacitidine treatment[J].Ann Hematol,2017,96(7):1097-1104.

    [28]

    Silverman LR,McKenzie DR,Peterson BL,et al.Further analysis of trials with azacitidine in patients with myelodysplastic syndrome:studies 8421,8921,and 9221 by the Cancer and Leukemia Group B[J].J Clin Oncol,2006,24(24):3895-3903.

    [29]

    Pomares H,Arnan M,Sanchez-Ortega I,et al.Invasive fungal infections in AML/MDS patients treated with azacitidine:a risk worth considering antifungal prophylaxis?[J].Mycoses,2016,59(8):516-519.

    [30]

    Steensma DP,Baer MR,Slack JL,et al.Multicenter Study of Decitabine Administered Daily for 5 Days Every 4 Weeks to Adults With Myelodysplastic Syndromes:The Alternative Dosing for Outpatient Treatment(ADOPT)Trial[J].J Clin Oncol,2009,27(23):3842-3848.

    [31]

    Kantarjian H,Issa JP,Rosenfeld CS,et al.Decitabine improves patient outcomes in myelodysplastic syndromes:results of a phase III randomized study[J].Cancer,2006,106(8):1794-1803.

    [32]

    Ali AM,Weisel D,Gao F,et al.Patterns of infectious complications in acute myeloid leukemia and myelodysplastic syndromes patients treated with 10-day decitabine regimen[J].Cancer Med,2017,6(12):2814-2821.

    [33]

    徐泽锋,秦铁军,张宏丽,等.地西他滨单药与CAG/HAG方案治疗难治性贫血伴有原始细胞增多的疗效和安全性比较[J].中华血液学杂志,2017,38(7):572-577.

    [34]

    焦蒙,肖志坚.去甲基化药物治疗骨髓增生异常综合征:治疗失败原因及其解决方案[J].临床血液学杂志,2019,32(3):229-233.

    [35]

    Girmenia C,Candoni A,Delia M,et al.Infection control in patients with myelodysplastic syndromes who are candidates for active treatment:Expert panel consensus-based recommendations[J].Blood Rev,2019,34:16-25.

    [36]

    Mallet V,van Bömmel F,Doerig C,et al.Management of viral hepatitis in patients with haematological malignancy and in patients undergoing haemopoietic stem cell transplantation:recommendations of the 5th European Conference on Infections in Leukaemia(ECIL-5)[J].Lancet Infect Dis,2016,16(5):606-617.

    [37]

    Ganzel C,Silverman B,Chemtob D,et al.The risk of tuberculosis in cancer patients is greatest in lymphoma and myelodysplastic syndrome/myeloproliferative neoplasm:a large population-based cohort study[J].Leuk Lymphoma,2019,60(3):720-725.

    [38]

    Maertens JA,Girmenia C,Bruggemann RJ,et al.European guidelines for primary antifungal prophylaxis in adult haematology patients:summary of the updated recommendations from the European Conference on Infections in Leukaemia[J].J Antimicrob Chemother,2018,73(12):3221-3230.

    [39]

    Lee JH,Lee KH,Lee JH,et al.Decreased incidence of febrile episodes with antibiotic prophylaxis in the treatment of decitabine for myelodysplastic syndrome[J].Leuk Res,2011,35(4):499-503.

    [40]

    Hutzschenreuter F,Monsef I,Kreuzer KA,et al.Granulocyte and granulocyte-macrophage colony stimulating factors for newly diagnosed patients with myelodysplastic syndromes[J].Cochrane Database Syst Rev,2016,2:CD009310.

    [41]

    Angelucci E,Li J,Greenberg P,et al.Iron Chelation in Transfusion-Dependent Patients With Low-to Intermediate-1-Risk Myelodysplastic Syndromes:A Randomized Trial[J].Ann Intern Med,2020,172(8):513-522.

    [42]

    Bitterman R,Eliakim-Raz N,Vinograd I,et al.Influenza vaccines in immunosuppressed adults with cancer[J].Cochrane Database Syst Rev,2018,2(2):CD008983.

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收稿日期:  2020-06-20

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