Chemaly et al studied cytomegalovirus (CMV) pneumonia in patients with malignant lymphoma. They identified risk factors associated with mortality after onset of the viral pneumonia. The authors are from the University of Texas M.D. Anderson Cancer Center in Houston.
Patient selection: Hodgkin's lymphoma, B cell non-Hodgkin's lymphoma, T cell non-Hodgkin's lymphoma
Parameters:
(1) APACHE II score at onset of the CMV pneumonia
(2) organ toxicity associated with antiviral agents
Criteria for organ toxicity secondary to antiviral agents:
(1) hematologic: >= 50% decrease from baseline neutrophil count
(2) renal: >= 50% increase from baseline serum creatinine
(3) other toxic reactions are not listed but could occur
Parameter
Finding
Points
APACHE II score
<= 16
0
> 16
1
antiviral toxicity
none
0
hematologic and/or renal toxicity
1
number of risk factors for mortality =
= SUM(points for both risk factors)
Risk Factor
3 Month Cumulative Survival Without Risk Factor
3 Month Cumulative Survival with Risk Factor
APACHE II > 16
85%
24%
antiviral toxicity
87%
37%
from Figure 1, page 1218
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