Uticaj antigljivične profilakse na pojavu gljivičnih infekcija kod bolesnika u programu alogene transplantacije

Jelena Cakic; Irena  Đunić

doi:10.5937/smclk2-32279

Jelena Cakic Medicinski fakultet u Beogradu
Irena Đunić Klinika za hematologiju Kliničkog Centra Srbije, Medicinski fakultet Univerziteta u Beogradu

DOI: https://doi.org/10.5937/smclk2-32279

Ključne reči: antigljivična profilaksa, invazivne gljivične infekcije, aspergiloza, antigen

Sažetak

Uvod/Cilj: Bolesnici sa hematološkim malignitetima kao što su akutna mijeloidna leukemija i akutna limfoblastna leukemija (AML/ALL), mijelodisplastični sindrom (MDS) i oni koji su podvrgnuti alogenoj transplantaciji matičnih ćelija (allo SCT) su u najvećem riziku od nastanka invazivnih gljivičnih infekcija (IFI). Najčešći među uzročnicima su Candida spp. i Aspergillus spp. Među strategijama za prevenciju nastanka IFI je blagovremena i adekvatna primena antigljivične profilakse koju preporučuje NCCN (National Comprehensive Cancer Network). Cilj istraživanja bila je analiza pojave IFI kod ovih pacijenata, kao i uticaj i značaj pravovremene antigljivične profilakse na njihovo nastajanje.

Metode: U retrospektivnoj studiji ispitivano je 42 bolesnika, prosečne starosti 35 godina, koji su bili u programu allo SCT u periodu od 2017. do 2019. godine i kod kojih je primenjivana antigljivična profilaksa na Klinici za hematologiju, UKCS. Na osnovu informacija dobijenih iz istorija bolesti formirane su baze podataka. Statistička analiza podataka obuhvatala je metode deskriptivne i analitičke statistike i urađena je u SPSS programu.

Rezultati: Klinički manifestnu infekciju u vidu oralne kandidijaze imalo je 19 (45,2%) bolesnika, dok se plućna aspergiloza razvila kod svega 3 (7,1%) bolesnika. Statistički značajna povezanost postojala je između klinički manifestne aspergiloze (7,1%) i prisustva antigena (Galactomannan) kod ovih bolesnika (p<0,001). Utvrđena je i statistički značajna povezanost između klinički manifestne aspergiloze i slabosti kalema [ 2 (66,6%) vs. 1 (33,3%); p=0,016].

Zaključak: Primena adekvatne antigljivične profilakse značajno smanjuje incidencu pojave IFI kod bolesnika u programu allo SCT i na taj način doprinosi smanjenju morbiditeta i mortaliteta.

Ključne reči: antigljivična profilaksa, Mikafungin, Posakonazol, efikasnost profilakse

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