Evaluation of the effects of regulatory T cells on survival outcomes in patients with acute leukemia who developed febrile neutropenia

被引:0
作者
Calik, Sebnem [1 ]
Bilgir, Oktay [2 ]
Demir, Ismail [3 ]
Tosun, Selma [1 ]
Ozdemir, Yeliz [1 ]
机构
[1] Univ Hlth Sci, Izmir Bozyaka Training & Res Hosp, Infect Dis & Clin Microbiol Clin, Izmir, Turkiye
[2] Univ Hlth Sci, Izmir Bozyaka Training & Res Hosp, Hematol Clin, Izmir, Turkiye
[3] Univ Hlth Sci, Izmir Bozyaka Training & Res Hosp, Internal Med Clin, Izmir, Turkiye
关键词
Acute leukemia; febrile neutropenia; regulatory T cells; survival analysis; C-reactive protein; ANTIMICROBIAL THERAPY; CANCER; GUIDELINES; SEPSIS;
D O I
10.1177/03000605241276482
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Objectives Acute leukemia often leads to severe complications such as febrile neutropenia. Mortality rates remain high, underscoring the need for novel prognostic markers. Regulatory T cells (Tregs) have not been extensively studied in this context.Methods This prospective observational, single-center study included 114 patients diagnosed with acute leukemia. Tregs percentages were measured using flow cytometry. Statistical analyses involved logistic regression to identify factors significantly associated with survival.Results Of the 114 patients, 78 recovered, while 36 died. The median Treg percentages were 5.9% in patients under 65 years and 5.38% in those 65 and older. A lower percentage of Tregs was associated with higher mortality in the older group (p = 0.04). Multivariate analysis highlighted the presence of comorbidities, documented infections, and day seven C-reactive protein levels as significant predictors of survival.Conclusion This study supports the importance of monitoring chronic diseases and infection foci alongside traditional markers like C-reactive protein. Future research should explore the mechanistic roles of Tregs in immunosuppression and survival in this vulnerable population.
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共 23 条
[1]   A European organization for Research and Treatment of Cancer - International Antimicrobial Therapy Group study of secondary infections in febrile, neutropenic patients with cancer [J].
Akova, M ;
Paesmans, M ;
Calandra, T ;
Viscoli, C .
CLINICAL INFECTIOUS DISEASES, 2005, 40 (02) :239-245
[2]   Epidemiology and source of infection in patients with febrile neutropenia: A ten-year longitudinal study [J].
Al-Tawfiq, Jaffar A. ;
Hinedi, Kareem ;
Khairallah, Hanan ;
Saadeh, Bassam ;
Abbasi, Suhail ;
Noureen, Madeeha ;
Raza, Safia ;
Alkhatti, Adil .
JOURNAL OF INFECTION AND PUBLIC HEALTH, 2019, 12 (03) :364-366
[3]   Etiology and Factors Affecting Severe Complications and Mortality of Febrile Neutropenia in Children with Acute Leukemia [J].
Erbas, Irem Ceren ;
Guzin, Ayse Cakil ;
Alata, Silem Ozdem ;
Asrak, Hatice Karaoglu ;
Akansu, Ilknur ;
Akyol, Sefika ;
Ozlu, Canan ;
Tuefekci, Ozlem ;
Yilmaz, Sebnem ;
Oren, Hale ;
Belet, Nursen .
TURKISH JOURNAL OF HEMATOLOGY, 2023, 40 (03) :143-153
[4]   Diabetes and Cancer A consensus report [J].
Giovannucci, Edward ;
Harlan, David M. ;
Archer, Michael C. ;
Bergenstal, Richard M. ;
Gapstur, Susan M. ;
Habel, Laurel A. ;
Pollak, Michael ;
Regensteiner, Judith G. ;
Yee, Douglas .
DIABETES CARE, 2010, 33 (07) :1674-1685
[5]   Adoptive transfer of in vitro-stimulated CD4+CD25+ regulatory T cells increases bacterial clearance and improves survival in polymicrobial sepsis [J].
Heuer, JG ;
Zhang, TH ;
Zhao, JY ;
Ding, CJ ;
Cramer, M ;
Justen, KL ;
Vonderfecht, SL ;
Na, SQ .
JOURNAL OF IMMUNOLOGY, 2005, 174 (11) :7141-7146
[6]   Neutralization of interleukin-10 or transforming growth factor-β decreases the percentages of CD4+CD25+Foxp3+ regulatory T cells in septic mice, thereby leading to an improved survival [J].
Hiraki, Shuhichi ;
Ono, Satoshi ;
Tsujimoto, Hironori ;
Kinoshita, Manabu ;
Takahata, Risa ;
Miyazaki, Hiromi ;
Saitoh, Daizoh ;
Hase, Kazuo .
SURGERY, 2012, 151 (02) :313-322
[7]   Could Neutrophil CD64 Expression Be Used as a Diagnostic Parameter of Bacteremia in Patients with Febrile Neutropenia? [J].
Iris, Nur Efe ;
Yildirmak, Taner ;
Gedik, Habip ;
Simsek, Funda ;
Aydin, Demet ;
Demirel, Naciye ;
Yokus, Osman .
TURKISH JOURNAL OF HEMATOLOGY, 2017, 34 (02) :167-173
[8]   Approach to fever in patients with neutropenia: a review of diagnosis and management [J].
Keck, J. Myles ;
Wingler, Mary Joyce B. ;
Cretella, David A. A. ;
Vijayvargiya, Prakhar ;
Wagner, Jamie L. L. ;
Barber, Katie E. E. ;
Jhaveri, Tulip A. A. ;
Stover, Kayla R. R. .
THERAPEUTIC ADVANCES IN INFECTIOUS DISEASE, 2022, 9
[9]   Management of febrile neutropaenia: ESMO Clinical Practice Guidelines [J].
Klastersky, J. ;
de Naurois, J. ;
Rolston, K. ;
Rapoport, B. ;
Maschmeyer, G. ;
Aapro, M. ;
Herrstedt, J. .
ANNALS OF ONCOLOGY, 2016, 27 :v111-v118
[10]   Comparison of Presepsin, Procalcitonin, Interleukin-8 and C-Reactive Protein in Predicting Bacteraemia in Febrile Neutropenic Adult Patients with Haematological Malignancies [J].
Kostic, Irena ;
Gurrieri, Carmela ;
Piva, Elisa ;
Semenzato, Gianpietro ;
Plebani, Mario ;
Caputo, Ilaria ;
Vianello, Fabrizio .
MEDITERRANEAN JOURNAL OF HEMATOLOGY AND INFECTIOUS DISEASES, 2019, 11