演題詳細

一般口演 / Oral Session

一般口演 108 (Oral Session 108) :感染症・その他

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日程
2013年10月13日(日)
時間
16:00 - 17:00
会場
第14会場 / Room No.14 (札幌市教育文化会館 3F 研修室305)
座長・司会
岩崎 博道 (Hiromichi Iwasaki):1
1:福井大学医学部 感染制御部
 
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Severe infectious complications after intensive chemotherapy for acute leukemia

演題番号 : OS-3-185

小澤 幸泰 (Yukiyasu Ozawa):1、加藤 実穗 (Miho Kato):1、加賀谷 裕介 (Yusuke Kagaya):1、川島 直実 (Naomi Kawashima):1、鴨下 園子 (Sonoko Kamoshita):1、渡壁 恭子 (Kyoko Watakabe):1、横畠 絵美 (Emi Yokohata):1、金光 奈緒子 (Naoko Kanemitsu):1、倉橋 信悟 (Shingo Kurahashi):1、宮村 耕一 (Koichi Miyamura):1

1:Department of Hematology, Japanese Red Cross Nagoya First Hospital

 

Severe infections, such as pneumonia or sepsis, have been important complications after intensive chemotherapy for acute leukemia patients. Recently, it has been reported that potent anti-fungal drugs would be useful for prophylaxis of invasive fungal infection. In this study, we analyzed the incidence and outcome of infectious complications after intensive chemotherapy for acute leukemia during recent 5 years.Between Jan. 2008 and Dec. 2012, total 79 patients with acute leukemia received intensive chemotherapy in our hospital, 57 patients had acute myelogenous leukemia and 22 had acute lymphoblastic leukemia; median age 46 (16-68), male/female 55/24. All patients received polymyxin B for intestinal decontamination. For anti-fungal prophylaxis, 32 patients received fluconazole, 42 patients received itraconazole and 2 patients received voriconazole. Twenty-three of 79 patients died, however, only 2 patients died due to infectious complications after chemotherapy. Pneumonia was shown in 16 patients, including 4 probable and 6 possible fungal pneumonia patients. Bacteremia was detected in 14 patients, including 2 septic shock cases. They were treated with PMX and mechanical ventilation in ICU, and both of them were recovered with leukemia remission. Overall survival rate at 2 years is 73%.In conclusion, although severe infectious complications were sometimes shown after chemotherapy, prompt and proper treatment could improve the outcome. Furthermore, it is possible that intensification of anti-fungal prophylaxis would decrease the incidence of invasive fungus infection.

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