Clinical features and prognosis criteria bacterial pneumonia in patients chronic lympholic leukemia. Amurskii meditsinskii zhurnal.

Abstract

The purpose of the study was to study the characteristics of the course and prognosis criteria of bacterial pneumonia in patients with chronic lymphocytic leukemia (CLL). It has been established that the incidence of pneumonia increases during tumor progression. The highest incidence was noted in patients in stage C (J. Binet et all., 1981). The risk of pneumonia in CLL is associated with the following factors: severe hypogammaglobulinemia, status 3-4 on the ECOG scale, stage C according to the Binet classification, relapse of CLL. Both nosocomial (NP) 47% (of which early 25%, late 75%) and community-acquired (53%) pneumonia (CP) were diagnosed. NPs in CLL often have hidden (25%) and low-symptomatic variants (32.5%). In most cases, VP is characterized by a typical course of the inflammatory process. In CLL, gramnegative flora (56%), as the causative agent of NP, predominates over gram-positive flora (44%); with CAP, gram-positive flora (74%) predominates over gram-negative flora (26%). Most pneumonia is characterized by a severe and protracted course. The unfavorable prognosis of pneumonia in CLL is due to such predictors as: latent variant of the course, stage C according to the J. Binet classification, 3-4 degree of comorbidity on the CIRS scale for diseases of the cardiovascular and respiratory systems, severity of the condition more than 16 points. on the APACHE II scale, status 3-4 on the ECOG scale, identification of Klebsiella pneumonia as the causative agent, age over 60 years, bilateral localization of pneumonia, association of microorganisms that cause pneumonia, presence of severe thrombocytopenia and hemorrhagic syndrome, severe hypogammaglobulinemia, occurrence of pneumonia in the hospital.