Clinical Characteristics and Risk Factors of Invasive Fungal Infections in Acute Leukemia Patients in Tropical Regions.
10.19746/j.cnki.issn.1009-2137.2022.01.016
- Author:
Wen-Shuai ZHENG
1
;
Li-Xun GUAN
1
;
Shen-Yu WANG
2
;
Ya-Lei HU
1
;
Bo PENG
2
;
Jian BO
2
;
Quan-Shun WANG
2
;
Xiao-Ning GAO
3
Author Information
1. Department of Hematology, Hainan Hospital of PLA General Hospital, Sanya 572000, Hainan Province, China.
2. Department of Hematology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China.
3. Department of Hematology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China,E-mail: gaoxn@263.net.
- Publication Type:Journal Article
- Keywords:
acute leukemia;
agranulocytosis;
anti-fungal prophylaxis;
hematopoietic stem cell transplantation;
inducing chemotherapy;
invasive fungal infection;
risk stratification
- MeSH:
Adult;
Aged;
Antifungal Agents/therapeutic use*;
Female;
Hematopoietic Stem Cell Transplantation;
Humans;
Invasive Fungal Infections/epidemiology*;
Leukemia, Myeloid, Acute/drug therapy*;
Male;
Middle Aged;
Retrospective Studies;
Risk Factors
- From:
Journal of Experimental Hematology
2022;30(1):99-106
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE: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.
METHODS: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.
RESULTS: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.
CONCLUSION: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.
