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The Need for Respiratory Support in Acute Leukemia: Frequency, Risk Factors and Prognosis
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Original Article
VOLUME: 53 ISSUE: 3
P: 378-383
2020

The Need for Respiratory Support in Acute Leukemia: Frequency, Risk Factors and Prognosis

Acta Haematol Oncol Turc 2020;53(3):378-383
DOI: 10.5505/aot.2020.15010
Burak Bilgin 1
Yahya Buyukasik 2
1. Hacettepe University, Department of Internal Medicine
2. Hacettepe University, Department of Heamatology
3.
No information available.
No information available
Received Date: 2020-03-20T13:39:34
Accepted Date: 2020-12-30T17:29:01
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Abstract

INTRODUCTION

Acute leukemia is a group of heterogeneous diseases characterized by proliferation of blastic cells in bone marrow. and high mortality and morbidity are seen during the disease and treatment course. In these patients, respiratory failure are found that related to the high mortalities. In this study, we aimed to determine rate of respiratory support, prognostic factors and risk factors for acute leukemia.

METHODS

All acute leukemia patients followed in our center between 2003 and 2014 were included in this study, retrospectively. Extra-pulmonary causes (neurological causes, hemodynamic instability and cardiopulmonary arrest) which were excluded from the statistical calculations for risk analysis and prognosis. Demographic characteristics of patients, respiratory support rate and etiologies, risk factors for respiratory failure and prognostic factors were determined and overall survival of patients who needed respiratory support was determined..

RESULTS

Totally, 460 patients included to the study. The rate of respiratory support was 30.6% (139/460) and pneumonia was the most common cause of respiratory failure. In multivariate analysis, age, ECOG performance status, febrile neutropenia prophylaxis, pulmonary infiltration during neutropenia episode and induction or reinduction chemoterapies were determined as independent risk factors for respiratory failure in acute leukemia. A statistical model for risk prediction was developed based on regression coefficient of independent risk factors, and 6 points and more were considered as high risk. The 60-days overall survival of patients who needed mechanical ventilation was 5.5%.

DISCUSSION AND CONCLUSION

In this study, we found that the need for respiratory support during acute leukemia treatment was quite frequent. As determination of high risk patients may provide important clinical benefits, validation of our risk scoring system by appropriately designed studies has utmost importance.