文章：

CPX-351治疗的急性髓系白血病患者肛周感染的发病率及特征

Incidence and Characteristics of Perianal Infections in CPX-351-Treated AML Patients

原文发布日期：9 January 2026

DOI: 10.3390/cancers18020208

类型: Article

开放获取: 是

英文摘要：

Background:Perianal infections (PIs) are a serious threat in patients with acute myeloid leukemia (AML). While CPX-351 is designed to reduce gastrointestinal toxicity, its impact on the incidence of PIs is unknown. This study aims to evaluate the incidence and characteristics of PIs in a cohort of CPX-351-treated AML patients.Methods:We enrolled 22 adult patients diagnosed with secondary AML receiving CPX-351 between May 2020 and July 2025 at Policlinico Tor Vergata Hospital. Statistical analysis used descriptive statistics and multivariate analysis.Results:The incidence of PIs in the cohort was 31.8%. Microbiological cultures from the lesions commonly yieldedKlebsiella pneumoniaeandEnterococcus species. The development of a PI was associated with a significantly longer hospital stay (mean, 49.6 vs. 37.7 days;p= 0.034). An increased odds ratio of having PIs was noted for mucositis and positive rectal swabs (17.961,p= 0.062; 5.554,p= 0.391, respectively), with two patients (28.5%) having a positive pre-infection swab forKlebsiella pneumoniae. Surgical intervention was guided by patient pain levels and hematological criteria. Surgical patients had significantly higher pain levels (p= 0.001) and a platelet count greater than 20 × 109/L (p= 0.028). All patients were alive at 30 days, with low rates of septic shock (14.2%, n = 1) and no infection-related mortality or recurrence.Conclusions:Despite CPX-351’s known reduced gastrointestinal toxicity, our study showed a significantly higher incidence of PIs compared to literature data. While the outcomes were favorable, PIs led to prolonged hospitalization. Routine rectal swab surveillance could be a valuable tool for risk stratification and preemptive strategies.

摘要翻译： 

背景： 肛周感染是急性髓系白血病患者面临的一个严重威胁。尽管CPX-351旨在降低胃肠道毒性，但其对肛周感染发生率的影响尚不明确。本研究旨在评估一组接受CPX-351治疗的AML患者中肛周感染的发生率及特征。

方法： 我们纳入了2020年5月至2025年7月期间在托尔·维尔加塔综合医院诊断为继发性AML并接受CPX-351治疗的22例成年患者。统计分析采用描述性统计和多变量分析。

结果： 该队列中肛周感染的发生率为31.8%。从病变处采集的微生物培养物常检出肺炎克雷伯菌和肠球菌属。发生肛周感染与住院时间显著延长相关（平均49.6天 vs. 37.7天；p=0.034）。黏膜炎和直肠拭子阳性（比值比分别为17.961，p=0.062；5.554，p=0.391）与发生肛周感染的比值比增加相关，其中两名患者（28.5%）在感染前拭子检出肺炎克雷伯菌阳性。手术干预根据患者疼痛水平和血液学指标决定。接受手术的患者疼痛水平显著更高（p=0.001）且血小板计数大于20×10⁹/L（p=0.028）。所有患者30天内存活，感染性休克发生率低（14.2%，n=1），无感染相关死亡或复发。

结论： 尽管已知CPX-351可降低胃肠道毒性，但我们的研究显示，与文献数据相比，肛周感染的发生率显著更高。虽然预后良好，但肛周感染导致了住院时间延长。常规直肠拭子监测可能成为风险分层和先发性治疗策略的有价值工具。

原文链接：

Incidence and Characteristics of Perianal Infections in CPX-351-Treated AML Patients