急性髓系白血病化疗合并感染的危险因素及风险评估

Risk factors and risk assessment of chemotherapy-associated infection in acute myeloid leukemia

急性髓系白血病(acute myeloid leukemia,AML)是一种血液系统恶性肿瘤,是成人中最常见的急性白血病[1],其特征在于骨髓祖细胞的克隆扩增和分化停滞,导致白血病细胞在骨髓、外周血中以及其他组织中积聚,而正常红细胞、血小板和完全分化的白细胞减少[2]。尽管近年来AML在发病机制、诊断分析和新疗法的发展方面取得了相当大的进展,但治疗方法并没有实质性的改变[3]。

Chemotherapy complicated with infection in acute myeloid leukemia(AML) has been a hot topic in hematology research. Chemotherapy is the main treatment for AML, and the adverse events caused by chemotherapy are not to be underestimated. Among them, infection is the most common adverse events. There are many risk factors for infection. It is generally believed that AML chemotherapy-complicated infection is associated with primary disease and chemotherapy-related immunodeficiency, patient-specific risk factors, and treatment-related skin and mucous membrane injury. In AML patients, infection not only affects the treatment effect, but also leads to an increase of mortality. Therefore, the risk assessment of infection after chemotherapy is very important, and MASCC score combined with individual risk factors is of certain value in predicting the risk of infection. Herein, we reviewed the latest knowledge of risk factors and risk assessment for infection following AML chemotherapy, so as to help the prevention and treatment of AML chemotherapy-associated infection.