Epidemiology and risk factors for invasive fungal infections during induction chemotherapy for newly diagnosed acute myeloid leukemia: A retrospective cohort study

This study investigated the epidemiology and risk factors associated with invasive fungal infections (IFIs) during induction chemotherapy in a cohort of Taiwanese patients with newly-diagnosed acute myeloid leukemia (AML). IFIs are a significant complication in the management of immunocompromised ca...

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Bibliographic Details
Published in:PloS one 2018-06, Vol.13 (6), p.e0197851-e0197851
Main Authors: Lien, Ming-Yu, Chou, Chia-Hui, Lin, Ching-Chan, Bai, Li-Yuan, Chiu, Chang-Fang, Yeh, Su-Peng, Ho, Mao-Wang
Format: Article
Language:English
Subjects:
Acute myelocytic leukemia
Acute myeloid leukemia
Adult
Aged
Antifungal agents
Antifungal Agents - pharmacology
Aspergillosis
Biology and Life Sciences
Cancer
Candida
Chemotherapy
Clinical medicine
Cohort analysis
Complications and side effects
Data processing
Drug therapy
Epidemiology
Female
Fever
Fungal infections
Fungi
Fungicides
Health aspects
Health risks
Hematology
Hospitals
Humans
Incidence
Induction Chemotherapy - adverse effects
Infections
Infectious diseases
Intensive care
Internal medicine
Invasive Fungal Infections - chemically induced
Invasive Fungal Infections - epidemiology
Invasive Fungal Infections - prevention & control
Invasiveness
Leukemia
Leukemia, Myeloid, Acute - drug therapy
Leukemia, Myeloid, Acute - microbiology
Lungs
Male
Males
Medical diagnosis
Medicine
Medicine and Health Sciences
Middle Aged
Morbidity
Mortality
Mucormycosis
Multivariate analysis
Mycoses
Myeloid leukemia
Neutropenia
Nutrition
Oncology
Parenteral nutrition
Patient outcomes
Patients
Prophylaxis
Retrospective Studies
Risk analysis
Risk Factors
Sinusitis
Yeast
Young Adult
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Summary:This study investigated the epidemiology and risk factors associated with invasive fungal infections (IFIs) during induction chemotherapy in a cohort of Taiwanese patients with newly-diagnosed acute myeloid leukemia (AML). IFIs are a significant complication in the management of immunocompromised cancer patients; such infections are associated with a high incidence of morbidity and mortality, particularly in many South-Asian countries, where IFI rates are increasing. We retrospectively analyzed IFI incidence data from 105 patients with newly diagnosed AML at a single center undergoing their first course of induction chemotherapy without primary antifungal prophylaxis between November 2008 and December 2014. Of 21 cases documented as proven/provable IFIs 16 (76%) were invasive aspergillosis, 2 (10%) were mucormycosis infections, and 3 (14%) were proven yeast infections. The lung was the most commonly affected site (n = 16; 76%); 2 patients (10%) developed fungal sinusitis. IFI cases were more often males (P = 0.020). In multivariate analysis, patients with neutropenia lasting>30 days were more than twice as likely to develop IFI (OR, 2.24 [95% CI, 2.81-31.11], P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0197851