Corticosteroid Therapy for Diffuse Alveolar Hemorrhage with Respiratory Failure in Hematologic Malignancies: A Retrospective Cohort Study.

IF 2.8 3区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics
Therapeutics and Clinical Risk Management Pub Date : 2025-05-17 eCollection Date: 2025-01-01 DOI:10.2147/TCRM.S520299
Jee Hwan Ahn, Kyung Mee Song, Jin Won Huh, Jung-Hee Lee, Sang-Bum Hong, Je-Hwan Lee, Chae-Man Lim, Kyoo-Hyung Lee, Younsuck Koh
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引用次数: 0

Abstract

Background: Although DAH in hematopoietic stem cell transplantation recipients is commonly treated with systemic corticosteroids, the efficacy of steroid therapy on DAH with respiratory failure in hematologic malignancy patients has not been studied. We aimed to investigate the effectiveness of steroid therapy in hematologic malignancy patients who developed DAH with respiratory failure and required treatment in the intensive care unit (ICU).

Methods: Among DAH patients with leukemia, lymphoma, or multiple myeloma, those who were not admitted to the ICU were excluded. Included patients were classified into the steroid or control group according to steroid therapy. Patient data were retrospectively collected from electrical medical records. The primary outcome was ICU mortality.

Results: A total of 44 patients (steroid group, n = 32; control group, n = 12) were included. At the DAH diagnosis, the steroid group was less likely to have a history of previously treated solid malignancy (3% vs 25%; P = 0.025) compared to the control group. ICU mortality in the steroid group was not significantly different from that in the control group (66% vs 67%; P = 0.948). Only in the steroid group, the ratio of arterial oxygen partial pressure to fractional inspired oxygen was significantly improved after 2 days from the DAH diagnosis (151 ± 64 vs 120 ± 38 mm Hg; P = 0.039).

Conclusion: Hematologic malignancy patients who developed DAH with respiratory failure and were admitted to the ICU had high mortality, irrespective of steroid therapy.

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恶性血液肿瘤弥漫性肺泡出血合并呼吸衰竭的皮质类固醇治疗:一项回顾性队列研究。
背景:虽然造血干细胞移植受者的DAH通常采用全身皮质类固醇治疗,但类固醇治疗血液恶性肿瘤患者DAH合并呼吸衰竭的疗效尚未研究。我们的目的是研究类固醇治疗对血液恶性肿瘤患者的有效性,这些患者发展为DAH并伴有呼吸衰竭,需要在重症监护病房(ICU)治疗。方法:在合并白血病、淋巴瘤或多发性骨髓瘤的DAH患者中,排除未入住ICU的患者。根据类固醇治疗情况将患者分为类固醇组和对照组。回顾性地从电病历中收集患者资料。主要终点是ICU死亡率。结果:共44例患者(类固醇组,n = 32;对照组,n = 12)。在DAH诊断时,类固醇组不太可能有既往治疗过的实体恶性肿瘤史(3% vs 25%;P = 0.025)。类固醇组ICU死亡率与对照组无显著差异(66% vs 67%;P = 0.948)。仅在类固醇组,在DAH诊断后2天动脉氧分压与分数吸入氧的比值显著改善(151±64 vs 120±38 mm Hg;P = 0.039)。结论:血液恶性肿瘤合并呼吸衰竭并发DAH并入住ICU的患者死亡率高,与类固醇治疗无关。
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来源期刊
Therapeutics and Clinical Risk Management
Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-
CiteScore
5.30
自引率
3.60%
发文量
139
审稿时长
16 weeks
期刊介绍: Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.
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