The risk factors of secondary infection in breast cancer or lung cancer patients with chemotherapy-induced degree Ⅳ neutropenia: a case-control study_Chinese Journal of Evidence-Based Medicine

Authors：

FAN Di ¹ , YOU Haisheng ¹ , LI Hong ¹ , HE Yinli ¹ , TANG Lina ¹ , ZHANG Wei ¹ ,  LV Jun ²

1. Department of Pharmacy, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, P.R.China;
2. Clinical Research Centre, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, P.R.China;

Corresponding author：

LV Jun, Email: lujun2006@xjtu.edu.cn

Keywords：

Breast cancer; Lung cancer; Neutropenia; Infection; Case-control study

DOI：

10.7507/1672-2531.201706037

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Objectives To analyze the risk factors of secondary infections in breast cancer or lung cancer patients with chemotherapy-induced degree Ⅳ neutropenia, so as to provide reference for clinical treatment. Methods The case-control study design was used. Thirty-seven in-patients of breast cancer or lung cancer with secondary infections and 87 in-patients without secondary infection in the First Affiliated Hospital of Xi’an Jiaotong University from January to December 2014 were enrolled as study population. We collected the retrospective information and analyzed the risk factors of secondary infection with chemotherapy-induced degree Ⅳ neutropenia using factors under univariate analysis and logistic regression analysis. Results Single factor analysis showed that the patients whose MASCC<21 the had higher infection risks (P<0.05). For breast cancer patients with degree Ⅳ neutropenia, secondary infection risk of first two chemotherapy cycles was 2.87 times of subsequent cycles of chemotherapy. For lung cancer patients with degree Ⅳ neutropenia, invasive procedures and preventive use of antibiotics increased risk of infection (P<0.05). Logistic regression analysis showed MASCC score and chemotherapy cycles were significantly associated with secondary infection in breast cancer degree Ⅳ neutropenia patients (P<0.05). Invasive procedures were significantly correlated to secondary infection of patients with lung cancer degree Ⅳ neutropenia (P<0.05). Conclusions MASCC score and chemotherapy cycles are the risk factors of infection in breast cancer patients with degree Ⅳ neutropenia, and invasive procedures are the independent risk factors of infection in lung cancer patients with degree Ⅳ neutropenia.

Citation： FAN Di, YOU Haisheng, LI Hong, HE Yinli, TANG Lina, ZHANG Wei, LV Jun. The risk factors of secondary infection in breast cancer or lung cancer patients with chemotherapy-induced degree Ⅳ neutropenia: a case-control study. Chinese Journal of Evidence-Based Medicine, 2018, 18(4): 306-310. doi: 10.7507/1672-2531.201706037 Copy

1.	李亚丽, 肖佳灵, 杨克虎, 等. 卡培他滨联合多西紫杉醇治疗转移性乳腺癌的系统评价. 中国循证医学杂志, 2009, 9(8): 893-898.
2.	米登海, 李征, 田金徽, 等. 热放化三联疗法治疗非小细胞肺癌的 Meta 分析. 中国循证医学杂志, 2011, 11(11): 1262-1267.
3.	王大志, 庄安士, 张书瑜. 抗肿瘤药与呼吸系统恶性肿瘤化疗患者骨髓抑制发生风险的 Logistic 回归分析. 药物流行病学杂志, 2012, 21(8): 365-367.
4.	李莉, 张萍, 康焕珍, 等. 肿瘤化疗骨髓抑制期医院感染的危险因素分析. 中华医院感染学杂志, 2013, 23(18): 4394-4398.
5.	常瑞, 张慧敏. 肿瘤患者化疗期间Ⅳ度骨髓抑制致院内感染的护理. 中国临床护理, 2015, 7(4): 333-334.
6.	ESMO. ESMO recommendations for the application of hematopoietic growth factors (rGFs). Ann Oncol, 2001, 12(9): 1219-1220.
7.	胡萨萨, 尤海生. 化疗致肺癌患者粒细胞减少危险因素的回顾性分析. 药物流行病学, 2015, 24(6): 356-357.
8.	程伏林, 胡名柏, 袁宏银. 化疗所致粒细胞缺乏症患者医院感染危险因素的多因素 Cox 模型分析. 中华医院感染学杂志, 2002, 12(5): 327-328.
9.	中国医学会血液学分会. 中国粒细胞缺乏伴发热患者抗菌药物临床应用指南. 中国血液学杂志, 2016, 37(5): 353-358.
10.	阮燕萍. 化疗致粒细胞缺乏症者发热及感染的病例对照研究. 杭州: 浙江大学, 2007: 11, 18-19.
11.	Combariza JF, Lombana M, Pino LE, et al. C-reactive protein and the MASCC risk index identify high-risk patients with febrile neutropenia and hematologic neoplasms. Support Care Cancer, 2015, 23(4): 1009-1013.
12.	Klastersky J, Paesmans M. The Multinational Association for Supportive Care in Cancer (MASCC) risk index score: 10 years of use for identifying low-risk febrile neutropenic cancer patients. Surport Care Cancer, 2013, 21(5): 1487-1495.
13.	余树娥, 汪蓓, 徐建华. rhG-GSF 对肿瘤患者化疗后白细胞减少及粒细胞缺乏的疗效. 湖南医学, 2002, 19(2): 100-101.
14.	王军, 刘勇. MASCC 危险指数评分和降钙素原应用于血液病化疗后粒细胞缺乏伴发热的价值. 实用医学杂志, 2015, 31(8): 1277-1279.
15.	阮艳萍, 张文英. 化疗致粒细胞缺乏症患者发热与感染的关系. 癌症, 2008, 27(8): 879-881.
16.	李伟伟, 崔艳慧, 蔡卫梅. 肺癌患者化疗期间发生感染的相关危险因素分析. 中国医院感染学杂志, 2013, 23(6): 1277-1278.
17.	张强. 细胞集落刺激因子和抗菌药物预防化疗所致粒细胞缺乏症患者院内感染的疗效观察. 中国实验和临床感染病杂志, 2013, 7(4): 108-109.
18.	程伏林, 胡名柏, 林从尧, 等. 化疗致粒细胞缺乏症患者的院内感染. 实用癌症杂志, 2001, 16(6): 613.

1. 李亚丽, 肖佳灵, 杨克虎, 等. 卡培他滨联合多西紫杉醇治疗转移性乳腺癌的系统评价. 中国循证医学杂志, 2009, 9(8): 893-898.
2. 米登海, 李征, 田金徽, 等. 热放化三联疗法治疗非小细胞肺癌的 Meta 分析. 中国循证医学杂志, 2011, 11(11): 1262-1267.
3. 王大志, 庄安士, 张书瑜. 抗肿瘤药与呼吸系统恶性肿瘤化疗患者骨髓抑制发生风险的 Logistic 回归分析. 药物流行病学杂志, 2012, 21(8): 365-367.
4. 李莉, 张萍, 康焕珍, 等. 肿瘤化疗骨髓抑制期医院感染的危险因素分析. 中华医院感染学杂志, 2013, 23(18): 4394-4398.
5. 常瑞, 张慧敏. 肿瘤患者化疗期间Ⅳ度骨髓抑制致院内感染的护理. 中国临床护理, 2015, 7(4): 333-334.
6. ESMO. ESMO recommendations for the application of hematopoietic growth factors (rGFs). Ann Oncol, 2001, 12(9): 1219-1220.
7. 胡萨萨, 尤海生. 化疗致肺癌患者粒细胞减少危险因素的回顾性分析. 药物流行病学, 2015, 24(6): 356-357.
8. 程伏林, 胡名柏, 袁宏银. 化疗所致粒细胞缺乏症患者医院感染危险因素的多因素 Cox 模型分析. 中华医院感染学杂志, 2002, 12(5): 327-328.
9. 中国医学会血液学分会. 中国粒细胞缺乏伴发热患者抗菌药物临床应用指南. 中国血液学杂志, 2016, 37(5): 353-358.
10. 阮燕萍. 化疗致粒细胞缺乏症者发热及感染的病例对照研究. 杭州: 浙江大学, 2007: 11, 18-19.
11. Combariza JF, Lombana M, Pino LE, et al. C-reactive protein and the MASCC risk index identify high-risk patients with febrile neutropenia and hematologic neoplasms. Support Care Cancer, 2015, 23(4): 1009-1013.
12. Klastersky J, Paesmans M. The Multinational Association for Supportive Care in Cancer (MASCC) risk index score: 10 years of use for identifying low-risk febrile neutropenic cancer patients. Surport Care Cancer, 2013, 21(5): 1487-1495.
13. 余树娥, 汪蓓, 徐建华. rhG-GSF 对肿瘤患者化疗后白细胞减少及粒细胞缺乏的疗效. 湖南医学, 2002, 19(2): 100-101.
14. 王军, 刘勇. MASCC 危险指数评分和降钙素原应用于血液病化疗后粒细胞缺乏伴发热的价值. 实用医学杂志, 2015, 31(8): 1277-1279.
15. 阮艳萍, 张文英. 化疗致粒细胞缺乏症患者发热与感染的关系. 癌症, 2008, 27(8): 879-881.
16. 李伟伟, 崔艳慧, 蔡卫梅. 肺癌患者化疗期间发生感染的相关危险因素分析. 中国医院感染学杂志, 2013, 23(6): 1277-1278.
17. 张强. 细胞集落刺激因子和抗菌药物预防化疗所致粒细胞缺乏症患者院内感染的疗效观察. 中国实验和临床感染病杂志, 2013, 7(4): 108-109.
18. 程伏林, 胡名柏, 林从尧, 等. 化疗致粒细胞缺乏症患者的院内感染. 实用癌症杂志, 2001, 16(6): 613.

Chinese Journal of Evidence-Based Medicine

The risk factors of secondary infection in breast cancer or lung cancer patients with chemotherapy-induced degree Ⅳ neutropenia: a case-control study

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