FEATURES OF COMORBIDITY AND THE COURSE OF SEPSIS IN ONCOHEMATOLOGICAL PATIENTS

Abstract

The study aims to analyze the features of comorbidity and the nature of the course of sepsis in oncohematological patients. A comparative analysis of the clinical examination and observation data of 25 patients with lymphoproliferative diseases (multiple myeloma and lymphomas) was carried out. The patients were divided into four groups as follows: the first group included patients who had received cytostatic therapy with sepsis complications, while the third group comprised those without complications; the second and fourth groups included patients with autologous hematopoietic stem cell transplantation after the course of cytostatic therapy with and without sepsis complications, respectively. The statistical analysis of the data obtained was carried out with the nonparametric Mann–Whitney test, the χ2 test and Fisher’s exact test were used in the analysis of qualitative indicators with p < 0.05. There were pronounced stages of chronic cardiovascular pathology in groups with sepsis complications, including those with fatal outcomes, which demonstrated the critical importance of vascular disruption as an underlying disease in the development, course, and outcomes of sepsis. In the study of biomarkers reflecting the activity of inflammation and cellular damage, the level of C-reactive protein in both groups with sepsis statistically significantly differed from that of groups without sepsis, while the level of lactate dehydrogenase showed statistically
significant differences between the first and the corresponding third comparison group. A dramatic increase in the level of lactate dehydrogenase was detected in both groups with transplantation of autologous hematopoietic stem cells with and without sepsis complications. That corresponds to the literature data and is associated with an increase in the level of cell lysis following transplantation. There were no statistically significant differences in the level of thrombocytopenia (a typical marker value) between groups with sepsis and groups without sepsis. The earch for markers of risk and the severe course of sepsis require further research.