Background. Infections are an important cause of morbidity and mortality for acute lymphoblastic leukemia (ALL). However, the reports regarding risk factors of induction-related infection are roughly unknown/limited in adult T-ALL during induction chemotherapy. Methods. We performed a retrospective cohort study for the prevalence and risk predictors of induction-related infection among consecutive T-ALL patients () enrolled in a PDT-ALL-LBL clinical trial. Of 97 patients with T-ALL enrolled in the trial, 46 were early T-cell precursor (ETP) ALL and 51 were non-ETP ALL. Results. When compared with non-ETP, ETP ALL subtype was characterized with lower neutrophil count (/L vs. /L, ) and lower myeloid percentage in the bone marrow (13.35% vs. 35.31%, ). Additionally, ETP ALL had longer neutropenia before diagnosis (), as well as during induction chemotherapy (). Notably, the ETP cohort experienced higher cumulative incidence of clinically documented infections (CDI; 33.33%, ), microbiologically documented infections (MDI; 45.24%, ), resistant infection (11.9%, ), and mixed infection (21.43%, ), respectively, than those of the non-ETP cohort. Furthermore, multivariable analysis revealed that T-ALL mixed infection was more likely related to chemotherapy response (OR, 0.025; 95% CI 0.127-0.64; ) and identified myeloid percentage as a predictor associated with ETP-ALL mixed infection (OR, 0.915; 95% CI 0.843-0.993; ), with ROC-defined cut-off value of 2.24% in ETP cohorts. Conclusions. Our data for the first time demonstrated that ETP-ALL characterized with impaired myelopoiesis were more susceptible to induction-related infection among T-ALL populations.

中文翻译：

---

在成人 T 细胞急性淋巴细胞白血病中，早期 T 细胞前体白血病具有较高的诱导相关感染风险

背景。感染是急性淋巴细胞白血病（ALL）发病率和死亡率的重要原因。然而，关于诱导相关感染危险因素的报道在成人 T-ALL 诱导化疗期间大致未知/有限。方法。我们对连续 T-ALL 患者中诱导相关感染的患病率和风险预测因素进行了一项回顾性队列研究（)参加了一项 PDT-ALL-LBL 临床试验。在参加试验的 97 名 T-ALL 患者中，46 名是早期 T 细胞前体 (ETP) ALL，51 名是非 ETP ALL。结果。与非 ETP 相比，ETP ALL 亚型的特点是中性粒细胞计数较低（/L 对比/L,)并降低骨髓中的骨髓百分比 (13.35% vs. 35.31%,）。此外，ETP ALL 在诊断前有较长的中性粒细胞减少症（），以及在诱导化疗期间（）。值得注意的是，ETP 队列的临床记录感染累积发生率较高（CDI；33.33%，),微生物记录的感染 (MDI; 45.24%,),耐药性感染 (11.9%,)和混合感染 (21.43%,)，分别比非 ETP 队列的那些。此外，多变量分析显示，T-ALL 混合感染更可能与化疗反应相关（OR，0.025；95% CI 0.127-0.64；)并确定骨髓百分比作为与 ETP-ALL 混合感染相关的预测因子 (OR, 0.915; 95% CI 0.843-0.993;)，在 ETP 队列中 ROC 定义的截止值为 2.24%。结论。我们的数据首次表明，以骨髓生成受损为特征的 ETP-ALL 在 T-ALL 人群中更容易受到诱导相关感染。