主要菌活性抗真菌预防降低了急性淋巴细胞白血病患者胸部计算机断层扫描的需要
Nihal Karadaş1, Hamiyet Hekimci Özdemir1, Yeşer Yilmaz2
1Ege University Faculty of Medicine, Children's Hospital, Department of Pediatric Hematology, IZMIR, Bornova, Turkey.
概括
与沃里可纳一起的抗真菌预防 (AFP) 显著减少了急性淋巴细胞白血病 (ALL) 儿童计算机断层扫描 (cCT) 胸部扫描的需要. 这种方法还降低了侵入性真菌感染和死亡率.
科学领域:
- 儿科瘤学 儿科瘤学
- 传染性疾病 传染性疾病
- 放射学 放射学是一门学科.
背景情况:
- 目前的指导方针建议为患有白血病的儿童进行胸部计算机断层扫描 (cCT) 扫描,以检测侵入性真菌感染 (IFI).
- cCT扫描使高风险儿科患者暴露在辐射中,增加二次癌症的风险.
研究的目的:
- 评估抗真菌预防 (AFP) 与沃里可纳 (VCZ) 对急性淋巴细胞白血病 (ALL) 儿童中cCT扫描的必要性的影响.
- 评估AFP是否可以减轻该脆弱人群中cCT扫描辐射暴露的需要.
主要方法:
- 对2013年2月之前被诊断患有ALL的儿童电子健康记录的回顾性分析.
- 两组的比较:那些接受模具活性AFP (伏利可纳) 的人与那些没有 (NoP组) 的人.
- 评估cCT扫描利用率,已证实-可能的IFI,以及各组之间的复发死亡率.
主要成果:
- 与NoP组相比,AFP组所需的cCT扫描显著减少 (52名儿童中64次扫描) (128名儿童中62次扫描).
- 在AFP组中,较少比例的患者至少需要一次cCT扫描.
- 与AFP组相比,NoP组表现出更高的被证明可能的IFI和复发死亡率.
结论:
- 用菌活性抗真菌预防,特别是使用沃里可纳,在接受ALL化疗的儿童中显著降低了对胸部cCT扫描的要求.
- 在管理IFI风险的同时,AFP是减少儿科ALL患者辐射暴露的有效策略.
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