Clinical Characteristics and Prognosis of Patients with Acute Leukemia Complicated with Mucormycosis after Chemotherapy
10.19746/j.cnki.issn1009-2137.2024.03.006
- VernacularTitle:急性白血病化疗后合并毛霉菌感染患者的临床特征及预后
- Author:
Ping-Ping ZHANG
1
;
Meng WANG
;
Yan JIN
;
Jun-Feng ZHU
;
Fang-Bing ZHU
;
Li-Li HAN
;
Yan-Li YANG
;
Feng ZHANG
;
Jia-Jia LI
Author Information
1. 蚌埠医学院第一附属医院血液科,安徽蚌埠 233000
- Keywords:
acute leukemia;
mucormycosis;
mNGS;
prognosis
- From:
Journal of Experimental Hematology
2024;32(3):685-692
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the characteristics and prognosis of patients with mucormycosis after chemotherapy for acute leukemia,and to strengthen understanding of the disease.Methods:7 cases of acute leukemia(AL)patients diagnosed with mucormycosis by metagenomic next generation sequencing(mNGS)after chemotherapy at the First Affiliated Hospital of Bengbu Medical College from October 2021 to June 2022 were collected,and their clinical data,including clinical characteristics,diagnosis,treatment,and prognosis,were retrospectively analyzed.Results:Among the 7 patients with AL complicated with mucormycosis,there were 3 males and 4 females,with a median age of 52(20-59)years.There were 6 cases of acute myeloid leukemia(AML)and 1 case of acute lymphocytic leukemia(ALL).Extrapulmonary involvement in 4 cases,including 1 case suspected of central nervous system involvement.The median time for the occurrence of mucor infection was 16(6-69)days after chemotherapy and 19(14-154)days after agranulocytosis.The main clinical manifestations of mucormycosis were fever(7/7),cough(3/7),chest pain(3/7)and dyspnea(1/7).The most common chest CT imaging findings were nodules,patchy or mass consolidation(6/7).All patients were treated with posaconazole or voriconazole prophylaxis during neutropenia phase.5 patients died within 8 months,and the median time from diagnosis to death was 1 month.Conclusion:Although prophylactic antifungal therapy is adopted,patients with acute leukemia still have a risk of mucor infection during the neutropenia phase.Fever is the main manifestation in the early stage of mucor infection.The use of intravenous antifungal drugs alone is ineffective and there is a high mortality rate in acute leukemia patients with mucormycosis.
