Invasive Fungal Disease in Patients with Newly Diagnosed Acute Myeloid Leukemia
| Autor: | Virginia Sheffield, Anastasia Wasylyshyn, Blair Richards, Kathleen A Linder, Marisa H. Miceli, Lydia Benitez Colon, Stephen Maurer, Carol A. Kauffman |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
Fusariosis medicine.medical_specialty mold infection QH301-705.5 Plant Science Neutropenia acute myeloid leukemia Aspergillosis Article Refractory Internal medicine hemic and lymphatic diseases medicine Biology (General) neoplasms Ecology Evolution Behavior and Systematics business.industry breakthrough fungal disease Myeloid leukemia Induction chemotherapy Retrospective cohort study medicine.disease invasive fungal disease Invasive fungal disease yeast infection business |
| Zdroj: | Journal of Fungi, Vol 7, Iss 761, p 761 (2021) Journal of Fungi Volume 7 Issue 9 |
| Popis: | This single-center retrospective study of invasive fungal disease (IFD) enrolled 251 adult patients undergoing induction chemotherapy for newly diagnosed acute myeloid leukemia (AML) from 2014–2019. Patients had primary AML (n = 148, 59%) antecedent myelodysplastic syndrome (n = 76, 30%), or secondary AML (n = 27, 11%). Seventy-five patients (30%) received an allogeneic hematopoietic cell transplant within the first year after induction chemotherapy. Proven/probable IFD occurred in 17 patients (7%). Twelve of the 17 (71%) were mold infections, including aspergillosis (n = 6), fusariosis (n = 3), and mucomycosis (n = 3). Eight breakthrough IFD (B-IFD), seven of which were due to molds, occurred in patients taking antifungal prophylaxis. Patients with proven/probable IFD had a significantly greater number of cumulative neutropenic days than those without an IFD, HR = 1.038 (95% CI 1.018–1.059), p = 0.0001. By cause-specific proportional hazards regression, the risk for IFD increased by 3.8% for each day of neutropenia per 100 days of follow up. Relapsed/refractory AML significantly increased the risk for IFD, HR = 7.562 (2.585–22.123), p = 0.0002, and Kaplan-Meier analysis showed significantly higher mortality at 1 year in patients who developed a proven/probable IFD, p = 0.02. IFD remains an important problem among patients with AML despite the use of antifungal prophylaxis, and development of IFD is associated with increased mortality in these patients. |
| Databáze: | OpenAIRE |
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