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To analyze the clinical characteristics and risk factors of invasive fungal infection (IFI) occurenced in patients with acute leukemia (AL) during treatment in tropical regions.The clinical data of 68 AL patients admitted to the Hainan Hospital of PLA General Hospital from April 2012 to April 2019 was retrospectively analyzed. Logistic regression analysis was used to analyze the factors affecting the occurrence of IFI in AL patients.Among the 68 patients, 44 were acute myeloid leukemia, 24 were acute lymphoblastic leukemia, 39 were male, 29 were female and the median age was 41(13-75) years old. The 68 patients received 242 times of chemotherapy or hematopoietic stem cell transplantation(HSCT), including 73 times of initial chemotherapy or inducting chemotherapy after recurrence, 14 times of HSCT, 155 times of consolidating chemotherapy. Patients received 152 times of anti-fungal prophylaxis, including 77 times of primary anti-fungal prophylaxis and 75 times of secondary anti-fungal prophylaxis. Finally, the incidence of IFI was 31 times, including 24 times of probable diagnosis, 7 times of proven diagnosis, and the total incidence of IFI was 12.8%(31/242), the incidence of IFI in inducting chemotherapy was 24.66%(18/73), the incidence of IFI in HSCT patients was 28.57% (4/14), the incidence of IFI in consolidating chemotherapy was 5.80% (9/155). Multivariate analysis showed that inducting chemotherapy or HSCT, the time of agranulocytosis ≥7 days, risk stratification of high risk were the independent risk factors for IFI in AL patients during treatment in tropical regions.The incidence of IFI in patients with AL in the tropics regions is significantly higher than that in other regions at homeland and abroad. Anti-fungal prophylaxis should be given to the patients with AL who have the high risk factors of inducting chemotherapy or HSCT, time of agranulocytosis ≥7 days and risk stratification of high risk.热带地区急性白血病患者侵袭性真菌感染的临床特点和危险因素.分析热带地区急性白血病(AL)患者治疗期间发生侵袭性真菌感染(IFI)的临床特点和危险因素.回顾分析中国人民解放军总医院海南医院2012年4月至2019年4月收治的68例AL患者的临床资料，采用Logistic回归分析影响AL患者IFI发生的因素.68例患者中急性髓系白血病44例，急性淋巴细胞白血病24例；男性39例，女性29例，中位年龄41(13-75)岁。68例患者共接受242例次化疗或造血干细胞移植(HSCT)，其中初治或复发后诱导化疗73例次，HSCT 14例次，巩固化疗155例次，患者共接受抗真菌预防治疗152例次，包括初级预防77例次，再次预防75例次。最终发生IFI 31例次，包括临床诊断IFI 24例次，确诊IFI 7例次，IFI总发生率为12.8%(31/242)，诱导化疗IFI发生率为24.66%(18/73)，HSCT IFI发生率为28.57%(4/14)，巩固化疗IFI发生率为5.80%(9/155)。多因素分析显示,诱导化疗或HSCT、粒缺时间≥7 d、危险度分层高危是热带地区AL患者治疗期间IFI发生的独立危险因素.热带地区AL患者治疗期间IFI发生率明显高于国内外其他地区，接受诱导化疗或HSCT、粒缺时间≥7 d和危险度分层为高危的AL患者发生IFI的风险高，应该进行抗真菌预防治疗. |
