Abstract: Objective To assess the clinical, laboratory, and chest CT data and identify prognostic factors in patients with hematological malignancies complicated by pulmonary mucormycosis. Method We retrospectively collected clinical, laboratory and chest imaging data from patients with hematological malignancies complicated by pulmonary mucormycosis who were admitted to the First Affiliated Hospital of Soochow University from January 2017 to June 2023. Patients were divided into a survival group (n=20) and a death group (n=26) and their clinical profiles, laboratory findings, and chest imaging characteristics were compared. The Kaplan-Meier survival analysis was used to identify the univariate factors affecting prognosis. Cox regression analysis was employed to evaluate factors associated with the risk of death. Result Kaplan-Meier analysis revealed that an unrelieved state of the bone marrow status of the primary disease (χ²=7.872, P=0.005), granulocytopenia at the initial diagnosis of mucormycosis infection (χ²= 5.160, P=0.023), renal insufficiency (χ²=5.818, P=0.016), hemoptysis (χ²=4.080, P=0.043), and pleural effusion (χ²=8.718, P=0.003) were associated with poor prognosis (P<0.05). Multivariate Cox regression analysis confirmed that non-remission of the primary disease bone marrow (OR=3.798, 95%CI 1.123-12.843) and pleural effusion (OR=3.176, 95%CI 1.180-8.549) were independent risk factors for poor prognosis (P<0.05), are independent risk factors for poor prognosis. The concordance index of this multivariate Cox regression model is 0.738, which indicates that the model has a moderate prognostic predictive performance. Conclusion Inadequate control of the primary hematological malignancy significantly increases mortality risk. Intensive management of the underlying hematological disease is critical for improving prognosis.

Key words: Hematological malignancies, Pulmonary mucormycosis, Computed tomography, Pleural effusion, Prognostic factors