The Influencing Factors of Pulmonary Infection after Chemotherapy in Acute Leukemia and the Construction of Prediction Model

TAN Qian; DONG Jiahua; ZHANG Min; FENG Juan; WANG Jing; LIANG Na

doi:10.3639/j.issn.2095-3097.2025.08.010

Abstract：Objective To investigate influencing factors of pulmonary infection after chemotherapy in patients with acute leukemia(AL)and construct a nomogram prediction model.Methods A total of 148 AL patients from the First Affiliated Hospital of Air Force Medical University between January 2023 and December 2024 were selected.According to pulmonary infection occurrence post-chemotherapy,patients were divided into infection group(n=52)and non-infection group(n=96).Differences in clinical data were compared.Multivariate logistic regression was used to analyze independent influencing factors for pulmonary infection.The nomogram prediction model was constructed using R software,and its predictive ability was evaluated by receiver operating characteristic(ROC)curve.Results Compared with the non-infection group,the infection group showed significantly higher proportions of age≥60 years,smoking history,ECOG score≥2,invasive procedures,proportion of primitive cell≥50%,high-intensity chemotherapy,white blood cell count<1×109/L,neutrophil count<0.5×109/L,neutropenia duration≥7 d,hemoglobin<90 g/L,and albumin(ALB)<35 g/L(P<0.05),while the proportion of empirical antibiotic use was significantly lower(P<0.05).Multivariate logistic regression showed that higher age(OR=1.581),invasive procedures(OR=1.861),lower neutrophil count(OR=1.219),longer neutropenia duration(OR=1.439),and lower ALB level(OR=1.294)were risk factors(P<0.05),while empirical antibiotic use(OR=0.678)was a protective factor(P<0.05).The AUC of the nomogram for predicting pulmonary infection was 0.905,with 78.95%sensitivity and 89.58%specificity.Conclusion The nomogram prediction model based on age,invasive procedures,neutrophil count,neutropenia duration,ALB level,and empirical antibiotic use exhibits strong predictive efficacy for pulmonary infection after AL chemotherapy.