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Yu Ling Lee-Tsai,Rodrigo Luna-Santiago,Roberta Demichelis-Gómez,Alfredo Ponce-de-León,Eric Ochoa-Hein,Karla María Tamez-Torres,María T Bourlon,Christianne Bourlon 대한혈액학회 2019 Blood Research Vol.54 No.2
BackgroundClostridium difficile infection (CDI) is a nosocomial condition prevalent in patients with hematological disorders. We aimed to identify the risk factors associated with the devel-opment of CDI and assess the mortality rate at 15 and 30 days among hematologic patients admitted to a tertiary care center.MethodsWe conducted a retrospective case-control study from January 2010 to December 2015. Forty-two patients with hematologic malignancy and CDI, and 84 with hematologic dis-ease and without history of CDI were included in the case and control groups, respectively.ResultsUnivariate analysis revealed that episodes of febrile neutropenia [odds ratio (OR), 5.5; 95% confidence interval (CI), 2.3‒12.9; P<0.001], admission to intensive care unit (OR, 3.8; 95% CI, 1.4‒10.2; P=0.009), gastrointestinal surgery (OR, 1.2; 95% CI, 1.1‒1.4; P<0.001), use of therapeutic (OR, 6.4; 95% CI, 2.5‒15.9; P<0.001) and prophylactic antibiotics (OR, 4.2; 95% CI, 1.6‒10.7; P=0.003) in the last 3 months, and >1 hospital-ization (OR, 5.6; 95% CI, 2.5‒12.6; P<0.001) were significant risk factors. Multivariate analysis showed that use of therapeutic antibiotics in the last 3 months (OR, 6.3; 95% CI, 2.1‒18.8; P=0.001) and >1 hospitalization (OR, 4.3; 95% CI, 1.7‒11.0; P=0.002) were independent risk factors. Three (7.1%) and 6 (14.2%) case patients died at 15 and 30 days, respectively.ConclusionThe risk factors for developing CDI were exposure to therapeutic antibiotics and previous hospitalization. Hematological patients who developed CDI had higher early mortality rates, suggesting that new approaches for prevention and treatment are needed.
AL A. Ávila Milord,María M. Aguilar Hernández,Roberta Demichelis Gómez 대한혈액학회 2018 Blood Research Vol.53 No.3
Background Extranodal NK/T-cell lymphoma, nasal type (ENKTCL) has a high prevalence in Asia and Latin American countries, such as Mexico, where it encompasses 40% of all T-cell non-Hodgkin lymphomas. Historically, responses to anthracycline-based therapies have been disappointing. Since data about the effectiveness of L-asparaginase-based regimens in Mexico are limited, we compared both therapies in our center. Methods We performed a retrospective cohort of patients with newly diagnosed ENKTCL, who were divided into two groups for treatment and analysis (group 1: L-asparaginase-based regimen and group 2: anthracycline-based regimen) between 2001 and 2016. Results Of 36 patients with newly-diagnosed ENKTCL, 33 received at least one cycle of chemo-therapy (22 in group 1 and 11 in group 2). Over a median follow-up interval of 17 months (range, 0‒167), a complete response (CR) was observed in 45.5% of patients in group 1, compared to 27% of group 2 (P=0.45). Progression was more frequently observed in group 2 than in group 1 (54.5% vs. 18.4%, P=0.04). The median overall survival (OS) was 44 months in group 1, compared to 5 months in group 2 (P=0.012). The multivariate analysis showed that failure to achieve a CR after first-line therapy was the only significant factor for OS (HR, 3.04; 95% CI, 1.4‒6.5; P=0.005). Conclusion L-asparaginase-based regimens for patients with newly-diagnosed ENKTCL confer a sur-vival advantage over anthracycline-based regimens.
AL A. Ávila Milord,María M. Aguilar Hernández,Roberta Demichelis Gómez 대한혈액학회 2018 Blood Research Vol.53 No.3
Background Extranodal NK/T-cell lymphoma, nasal type (ENKTCL) has a high prevalence in Asia and Latin American countries, such as Mexico, where it encompasses 40% of all T-cell non-Hodgkin lymphomas. Historically, responses to anthracycline-based therapies have been disappointing. Since data about the effectiveness of L-asparaginase-based regimens in Mexico are limited, we compared both therapies in our center. Methods We performed a retrospective cohort of patients with newly diagnosed ENKTCL, who were divided into two groups for treatment and analysis (group 1: L-asparaginase-based regimen and group 2: anthracycline-based regimen) between 2001 and 2016. Results Of 36 patients with newly-diagnosed ENKTCL, 33 received at least one cycle of chemo-therapy (22 in group 1 and 11 in group 2). Over a median follow-up interval of 17 months (range, 0‒167), a complete response (CR) was observed in 45.5% of patients in group 1, compared to 27% of group 2 (P=0.45). Progression was more frequently observed in group 2 than in group 1 (54.5% vs. 18.4%, P=0.04). The median overall survival (OS) was 44 months in group 1, compared to 5 months in group 2 (P=0.012). The multivariate analysis showed that failure to achieve a CR after first-line therapy was the only significant factor for OS (HR, 3.04; 95% CI, 1.4‒6.5; P=0.005). Conclusion L-asparaginase-based regimens for patients with newly-diagnosed ENKTCL confer a sur-vival advantage over anthracycline-based regimens.