| Aute leukemia (AL) is a kind of malignant clone disease of hematopoietic stem cell and accompanied by the original multi-organ's infiltration, which mainly because of primitive cells and immature cells abnormally proliferate in the bone marrow. The main death reason of acute leukemia are bleeding and infection. The survival and remission rate are obviously prolonged with the progress of the combined chemotherapy.However, the incidence of nosocomial infection is still higher because of the low-grade immune functions,the large dose of chemotherapy and the application of the immunosuppressants. The pulmonary infections are predominant complication and one of the main causes of death to the patients with AL.Objective:To improve the comprehension of motivation of hematological malignancies accompanied with pulmonary injury casued by chemotherapy ,to improve prevention,early diagnose and cute , reduce fungal infection, mortality rate and increase survival rate,improve the individualization of the treatment and the quality of the survival in patients with acute leukemia,improve the turnover and extend the period with disease free survival.Methods: A retrospective review of the medical records of 58 patients with acute leukemia who were diagnosed according to the clinical symptoms,the imageology,the cell morphology and the pathematology of the tissue from January 1, 2006 to December 30, 2008 in our hospital. The patients should have accept at least 1 couse of chemotherapy and the patients with the complete datas were brought into the study. A retrospective review has been carried out from the aspects of the sex,age,incidence of the nosocomial infections,chemotherapy,distribution of bacteria and the sensitivity of pathogenic bacterium. The statistical methods ofχ2 test and Logistic regression analysis have been taken to analyze the single factors and multiple factors of pulmonary infections caused by chemotherapy .Result:①The average morbidity of pulmonary infection caused by chemotherapy in 2006 and 2007 is 4.11%, The morbidity of pulmonary infections caused by chemotherapy in 2008 is 7.12%, The average morbidity of pulmonary infections caused by chemotherapy in 2006 and 2007 is lower than 2008.②Seven cases turn to acute respiratory distress syndrome after given high dose of Ara-C,one patient died because of respiratory failure.③Two cases turn to transfusion-related acute lung injury and be cured.④49 acute leukemia patients have pulmonary infection after chemotherapy,36 cases accept pathogenic examine and the most kind of bacteria was Gram-negative bacteria, such as Bacterium coli, Pseudomonas aeruginosa, Klebsiella pneumoniae. Enterococcus, and Staphylococcus aureus are common kinds of Gram-positive bacteria. The common kind of the fungus was Blastomyces albicans .⑤Accrording to the drug sensitivity test,in this study the Gram-negative bacterias were sensitivity to meropenem,ciprofloxacin and ceftazidime, but the sensitve rate of the ceftriaxone and cefotaxim were lower .The sensitivity of the Gram-positive bacteria were vancomycin and teicoplanin. The second sensitivity was imipenem. The sensitive radio of penicillin was the lowest.⑥The fungous infection rate was 10.2%. Only 1 cases of them have not received the treatment of antibiotics, and the rest have received the treatment of 1-3 kinds of antibiotics, which means fungous infection was related to the application of broad-spectrum antibiotic.⑦The analysis of the single factor showed that the age,type of leukemia,stage of treatment,absolute neutrophil count in peripheral blood,lasting time of agranulocytosis,length of hospitalization were relative to pulmonary injury (p<0.05), and then the main risks were the absolute neutrophil count in peripheral blood,lasting time of agranulocytosis,stage of treatment,length of hospitalization and the age according to the Logistic regression analysis.Conclusion:①The morbidity of pulmonary injury caused by chemotherapy increased by year. The etiology of pulmonary injury caused by infection showed that the bacterium was the most part of them. And the most of the bacteria was the Gram-negative bacteria, the ratio was 51.2%.②Patients with acute leukemia can turn to acute respiratory distress syndrome after given high dose of Ara-C.③Thouge the morbidity of transfusion-related acute lung injury is low, we should pay attention to it.④The main risks were the absolute neutrophil count in peripheral blood,lasting time of agranulocytosis,stage of treatment,length of hospitalization and the age according to the Logistic regression analysis. The most important risk is absolute neutrophil count in peripheral blood.
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