Invasive aspergillosis in relapsed/refractory acute myeloid leukaemia patients: Results from SEIFEM 2016‐B survey

Background In patients with relapsed/refractory acute myeloid leukaemia (R/R AML) who received salvage chemotherapy, limited and not updated studies explored the incidence of invasive aspergillosis (IA) and the role of antifungal prophylaxis (AP). The aims of this multicentre retrospective ‘SEIFEM 2...

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Published in:Mycoses 2022-02, Vol.65 (2), p.171-177
Main Authors: Del Principe, Maria Ilaria, Dragonetti, Giulia, Conti, Allegra, Verga, Luisa, Ballanti, Stelvio, Fanci, Rosa, Candoni, Anna, Marchesi, Francesco, Cattaneo, Chiara, Lessi, Federica, Fracchiolla, Nicola, Spolzino, Angelica, Prezioso, Lucia, Delia, Mario, Potenza, Leonardo, Decembrino, Nunzia, Castagnola, Carlo, Nadali, Gianpaolo, Picardi, Marco, Zama, Daniele, Orciulo, Enrico, Veggia, Barbara, Garzia, Mariagrazia, Dargenio, Michelina, Melillo, Lorella, Manetta, Sara, Russo, Domenico, Mancini, Valentina, Piedimonte, Monica, Tisi, Maria Chiara, Toschi, Nicola, Busca, Alessandro, Pagano, Livio
Format: Article
Language:English
Subjects:
Acute myeloid leukemia
Antifungal Agents - therapeutic use
antifungal prophylaxis
antifungal therapy
Aspergillosis
Aspergillosis - drug therapy
Aspergillosis - epidemiology
breakthrough infections
Chemotherapy
Humans
invasive aspergillosis
Invasive Fungal Infections - drug therapy
Invasive Fungal Infections - epidemiology
Leukemia
Leukemia, Myeloid, Acute - complications
Leukemia, Myeloid, Acute - drug therapy
Leukemia, Myeloid, Acute - microbiology
Mucositis
Multivariate analysis
Posaconazole
Prophylaxis
refractory acute myeloid leukaemia
relapsed acute myeloid leukaemia
Retrospective Studies
salvage chemotherapy
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Summary:Background In patients with relapsed/refractory acute myeloid leukaemia (R/R AML) who received salvage chemotherapy, limited and not updated studies explored the incidence of invasive aspergillosis (IA) and the role of antifungal prophylaxis (AP). The aims of this multicentre retrospective ‘SEIFEM 2016‐B’ study were as follows: (1) to evaluate the current rate and the outcome of proven/probable IA and (2) to assess the efficacy of AP, in a large ‘real life’ series of patient with R/R AML submitted to salvage chemotherapy. Results Of 2250 R/R AML patients, a total of 74 cases of IA (5.1%) were recorded as follows: 10 (0.7%) proven and 64 (4.3%) probable. Information about AP were available in 73/74 (99%) patients. Fifty‐eight (79%) breakthrough infections occurred, mainly during AP with posaconazole [25 (43%)]. The patients who received AP during salvage chemotherapy showed a benefit from antifungal therapy (AT) than patients who did not received AP [43 (86%) vs 7 (14%); p 
ISSN:0933-7407
1439-0507
DOI:10.1111/myc.13384