Mehmet GÜNDOĞDU, Murat POLAT, Yusuf BİLEN, İlhami KİKİ, Rahşan YILDIRIM, Nevzat BULUT, Gülden SİNCAN

Akut Myeloid Lösemili Hastalarda İndüksiyon Kemoterapisi Sonrası Gelişen Nötropeni Süresini Etkileyen Faktörler

GİRİŞ ve AMAÇ: AMAÇ: Akut myeloid lösemide nötropeniye bağlı gelişen enfeksiyonlar mortalitede önemli rol oynar. Bu nedenle, biz bu çalışmada akut myeloid lösemi nedeniyle indüksiyon kemoterapisi verilmiş hastalarda tedavi sonrası gelişen nötropeni süresini etkileyen faktörleri belirlemeyi amaçladık. YÖNTEM ve GEREÇLER: YÖNTEMLER: Bu çalışmada 60 hastanın tıbbi kayıtları retrospektif olarak incelendi. Komorbid durumlar, vücut kitle indeksi, başlangıç labaratuvar parametreleri, sitogenetik özellikler, immünfenotipik özellikler gibi parametreler kaydedildi. Bu parametrelerin nötropeni süresi üzerine etkileri araştırıldı. BULGULAR: Hastaların başlangıç lökosit değeri 42.525±101.364 mm³ , platelet sayısı 58.735±49.104 mm³ , nötropenik gün sayısı 21±8,3 gün, HLA-DR ve CD34 pozitiflik oranı sırasıyla 24,9±28,5% ve 28,5±33,4% idi. CD 117 pozitiflik oranı 30,6±27,2%, myeloperoksidaz pozitiflik oranı 53,4±37,5 % idi. Nötropenide kalış süresi ile platelet sayısı ve CD34 pozitiflik oranı ile anlamlı pozitif korelasyon, laktat dehidrogenaz düzeyi ve myeloperoksidaz pozitiflik oranı ile anlamlı negatif korelasyon saptandı. TARTIŞMA ve SONUÇ: SONUÇ: Erken myeloid belirteçlerin pozitifliğinin oranı arttıkça hastaların nötropenide kalış süresinin arttığı görüldü. Bu nedenle erken myeloid belirteci pozitif olan hastalar enfeksiyon riski nedeniyle daha dikkatli takip edilmelidir.

Anahtar Kelimeler:

Akut myeloid lösemi, febril nötropeni, risk faktörleri

Factors Affecting The Duration Of Neutropenia Which Occur After Induction Chemotherapy In Patıents With Acute Myeloid Leukemia

INTRODUCTION: OBJECTIVE: Infections due to neutropenia play an important role in mortality in acute myeloid leukemia. Therefore; we aimed to determine the factors that affect duration of neutropenia in patients who are given induction chemotherapy because of acute myeloid leukemia.METHODS: We examined medical records of the 60 patients retrospectively. We recorded comorbid conditions, body mass index, initial labaratory findings, immunophenotypic and cytogenetic characteristics. Effects of all these parameters on duration of neutropenia were investigated. RESULTS: Leukocyte value of patients was 42.525 ± 101.364 μL, platelets count was 58.735 ± 49.104 μL. Number of days with neutropenia was 21 ± 8.3. HLA-DR and CD34 positivity rate was 24.9 ± 28.5% and 28.5 ± 33.4% respectively. CD117 and myeloperoxidase positivity rate was 30.6 ± 27.2% and 53.4 ± 37.5% respectively. A significant positive corrrelation was found between duration of neutropenia and platelets value and positivity rate of CD34. A significant negative corrrelation was found between duration of neutropenia and initial lactate dehydrogenase levels and positivity rate of myeloperoxidase. DISCUSSION AND CONCLUSION: CONCLUSION: When positivity rate of early myeloid markers increased an increasing on duration of neutropenia was observed. Therefore; patients with early myeloid markers should be monitored more carefully because of the risk of infection.

Keywords:

Acute myeloid leukemia, febrile neutropenia, risk factors,

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