Risk factors for invasive fungal infection in 5-azacytidine treated patients with acute myeloid leukemia and myelodysplastic syndrome.
Aged
Aged, 80 and over
Antifungal Agents
/ therapeutic use
Azacitidine
/ adverse effects
Disease Susceptibility
Female
Humans
Incidence
Invasive Fungal Infections
/ drug therapy
Leukemia, Myeloid, Acute
/ complications
Male
Myelodysplastic Syndromes
/ complications
Neutropenia
/ diagnosis
Prognosis
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Treatment Outcome
Journal
European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
revised:
02
04
2021
received:
03
02
2021
accepted:
04
04
2021
pubmed:
9
4
2021
medline:
25
12
2021
entrez:
8
4
2021
Statut:
ppublish
Résumé
The rate of invasive fungal infection (IFI) in patients with myelodysplasia (MDS) and acute myeloid leukemia (AML) receiving 5-azacytidine is incompletely defined and published recommendations for mold-active fungal prophylaxis in such patients vary according to source. We performed a retrospective cohort study in order to identify contemporary IFI rates and infection-related mortality in relation to known risk factors and the use of antifungal prophylaxis. One hundred and seventeen patients receiving 5-azacytidine for MDS and low blast count AML were identified, of whom 71 (61%) received antifungal prophylaxis. The IFI rate was 7.7% across the entire cohort: 5.6% in those receiving prophylaxis vs 10.9% in the subgroup who did not (P = .30). The presence of neutropenia at three months of treatment was associated with increased IFI risk (hazard ratio [HR] 8.29; (95% confidence interval [CI)] 1.61-42.6; P = .01), and on multivariate analysis, IFI was independently associated with increased all-cause mortality risk (HR 8.37; 95% CI 3.67 - 19.11; P < .0001). These data further highlight the risk of IFI in this population and support the use of mold-active prophylaxis in neutropenic patients receiving 5-azacytidine for MDS and AML.
Substances chimiques
Antifungal Agents
0
Azacitidine
M801H13NRU
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
181-189Subventions
Organisme : Monash Haematology Research Grant
Informations de copyright
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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