Clinical features of invasive pulmonary fungal infection secondary to malignant blood diseases.
- Author:
Xue-Feng SUN
1
;
Bing HAN
;
Jun FENG
;
Dao-Bin ZHOU
;
Shu-Jie WANG
;
Ying XU
;
Jia-Lin CHEN
;
Li JIAO
;
Wei ZHANG
;
Jian LI
;
Ming-Hui DUAN
;
Tie-Nan ZHU
;
Nong ZOU
;
Bao-Lai HUA
;
Hua-Cong CAI
;
Yong-Qiang ZHAO
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Adult; Aged; Aged, 80 and over; Female; Hematologic Neoplasms; complications; Humans; Lung Diseases, Fungal; diagnosis; drug therapy; etiology; Male; Middle Aged; Retrospective Studies; Young Adult
- From: Acta Academiae Medicinae Sinicae 2009;31(5):575-579
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo summarize the clinical features of invasive pulmonary fungal infection (IPFI) secondary to malignant blood diseases (MBD).
METHODSWe retrospectively analyzed the clinical data of 52 patients with IPFI secondary to MBD admitted to Peking Union Medical College Hospital from January 1995 to December 2008.
RESULTSThe incidences of IPFI secondary to acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), non-Hodgkin's lymphoma (NHL), and aplastic anemia (AA) were 4.6%, 3.2%, 2.8%, and 2.5%, respectively. In patients with IPFI secondary to AML, 88.5% (23/26) of the patients suffered from the infections during the non-remission (NR) period (including relapse), and 11.5% (3/26) in the complete-remission (CR) period. In all the patients with IPFI secondary to malignant blood diseases, 86.5% (45/52) of MBD were neutropenic or agranulocytic, and 67.3% (35/52) had been treated with broad-spectrum antibiotics for more than 96 hours before anti-fungal therapy. The total mortality after anti-fungal therapy was 13.7% (7/51). More than half of patients with fluconazole or itraconazole as the first-line therapy had to switch to other medicines because of poor infection control.
CONCLUSIONSIPFI secondary to MBD is most common in AML patients. Patients with NR of AML, neutropenia or agranulocytosis, and long-term broad-spectrum antibiotics usage are susceptible to IPFI. Fluconazole and itraconazole have low efficacy, and other more potent anti-fungal medicines should be considered.