Anorectal Pathologies in the Course of Acute Leukaemias; Predictive Parameters.

IF 2 4区 医学 Q3 HEMATOLOGY
Fatma Yilmaz,Bugra Saglam,Ufuk Gorduk,Ugur Kalan,Hacer Berna Afacan Ozturk,Ahmet Kursad Gunes,Murat Albayrak
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Abstract

Introduction Patients with leukaemia are exposed to infections as long as they are neutropenic. During this period, anorectal pathologies are among the common foci of infection with high mortality. In this study, we aim to investigate the factors that may have a predictive effect on early diagnosis and rapid intervention in perianal complications occurring in neutropenic patients diagnosed with leukaemia. Materials and Methods A total of 90 patients with acute leukaemia, including 45 patients with anorectal pathology and 45 patients without anorectal pathology, were analysed. Demographics, blood group, BMI, haemogram and biochemical parameters at the time of diagnosis, and types of perianal pathology were recorded. Results In the group of patients with anorectal pathology, WBC, lymphocytes, monocytes, and LDH were significantly (p<0.05) higher, and platelets, MPV, and PCT were significantly (p<0.05) lower. The multivariate model showed significant-independent (p<0.05) efficacy of WBC and MPV values in differentiating patients with and without anorectal pathology. A significant efficacy was observed at the WBC cut-off of 17000 [area under the curve 0.656 (0.542-0.770)] and the MPV cut-off of 10 [area under the curve 0.667 (0.554-0.780)] in differentiating patients with and without anorectal pathology. Discussion Anorectal pathologies are common foci of infection in patients with acute leukaemia. Having predictive parameters that may help for early intervention will help the clinician. This is the first study in the literature to compare a control group with a group with anorectal pathologies in leukaemia patients providing a cut-off for WBC.
急性白血病病程中的肛门直肠病变;预测参数。
导言白血病患者只要处于中性粒细胞减少状态,就会受到感染。在此期间,肛门直肠病变是常见的感染病灶之一,死亡率很高。在本研究中,我们旨在探讨对确诊为白血病的中性粒细胞增多症患者肛周并发症的早期诊断和快速干预具有预测作用的因素。结果 在有肛门直肠病变的患者组中,白细胞、淋巴细胞、单核细胞和 LDH 显著增高(P<0.05),血小板、MPV 和 PCT 显著降低(P<0.05)。多变量模型显示,白细胞和 MPV 值在区分有肛门直肠病变和无肛门直肠病变患者方面具有明显的依赖性(p<0.05)。WBC临界值为17000[曲线下面积为0.656(0.542-0.770)]和MPV临界值为10[曲线下面积为0.667(0.554-0.780)]时,在区分有肛门直肠病变和无肛门直肠病变的患者方面有明显疗效。拥有有助于早期干预的预测参数将对临床医生有所帮助。这是文献中首次对白血病患者的对照组与肛门直肠病变组进行比较,并提供了白细胞的临界值。
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来源期刊
CiteScore
4.20
自引率
6.20%
发文量
113
审稿时长
12 weeks
期刊介绍: Reciprocal interdependence between infectious and hematologic diseases (malignant and non-malignant) is well known. This relationship is particularly evident in Mediterranean countries. Parasitosis as Malaria, Leishmaniosis, B Hookworms, Teniasis, very common in the southeast Mediterranean area, infect about a billion people and manifest prevalently with anemia so that they are usually diagnosed mostly by experienced hematologist on blood or bone marrow smear. On the other hand, infections are also a significant problem in patients affected by hematological malignancies. The blood is the primary vector of HIV infection, which otherwise manifest with symptoms related to a reduction in T lymphocytes. In turn, infections can favor the insurgency of hematological malignancies. The causative relationship between Epstein-Barr virus infection, Helicobacter pylori, hepatitis C virus, HIV and lymphoproliferative diseases is well known.
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