Pre-chemotherapy risk factors for invasive fungal diseases: prospective analysis of 1,192 patients with newly diagnosed acute myeloid leukemia (SEIFEM 2010-a multicenter study)

Abstract

Correct definition of the level of risk of invasive fungal infections is the first step in improving the targeting of preventive strategies. We investigated the potential relationship between pre-hospitalization exposure to sources of fungi and the development of invasive fungal infections in adult patients with newly diagnosed acute myeloid leukemia after their first course of chemotherapy. From January 2010 to April 2012, all consecutive acute myeloid leukemia patients in 33 Italian centers were prospectively registered. Upon first admission, information about possible pre-chemotherapy risk factors and environmental exposure was collected. We recorded data regarding comorbid conditions, employment, hygienic habits, working and living environment, personal habits, hobbies, and pets. All invasive fungal infections occurring within 30 days after the first course of chemotherapy were recorded. Of the 1,192 patients enrolled in this study, 881 received intensive chemotherapy and were included in the present analysis. Of these, 214 developed an invasive fungal infection, including 77 proven/probable cases (8.7%). Of these 77 cases, 54 were proven/probable invasive mold infections (6.1%) and 23 were proven yeast infections (2.6%). Upon univariate analysis, a significant association was found between invasive mold infections and age, performance status, diabetes, chronic obstructive pulmonary disease, smoking, cocaine use, job, hobbies, and a recent house renovation. Higher body weight resulted in a reduced risk of invasive mold infections. Multivariate analysis confirmed the role of performance status, job, body weight, chronic obstructive pulmonary disease, and house renovation. In conclusion, several hospital-independent variables could potentially influence the onset of invasive mold infections in patients with acute myeloid leukemia. Investigation of these factors upon first admission may help to define a patient's risk category and improve targeted prophylactic strategies. (Clinicaltrial.gov: NCT01315925) Pre-chemotherapy risk factors for invasive fungal diseases: prospective analysis of 1,192 patients with newly diagnosed acute myeloid leukemia (SEIFEM

How do I manage hyperglycemia/post-transplant diabetes mellitus after allogeneic HSCT

“…Patients with DM were reported to be at higher risk for invasive fungal diseases during chemotherapy. 42 In summary, the association between DM and infection is widely acknowledged.…”

Changes in the incidence of candidemia and related mortality in patients with hematologic malignancies in the last ten years. A SEIFEM 2015-B report

“…[6][7][8] Recent reports have shown that the incidence of candidemia is lower than in past years, probably because of the use of more effective prophylactic and/or therapeutic antifungal approaches. [1][2][3] Our epidemiological study compared two large multicenter cohorts of patients with hematologic malignancies who were treated with conventional chemotherapy or transplantation procedures during two different periods (before and after the introduction of the clinical practice of echinocandins and the latest-generation azoles, voriconazole and posaconazole). We observed that the overall incidence of candidemia in patients treated with conventional chemotherapy has decreased significantly, being markedly influenced by a relevant reduction of candidemia in AML patients.…”

“…Lucia Prezioso, 7 Marianna Criscuolo, 1 Simone Cesaro, 8 Mario Delia, 9 Rosa Fanci, 10 Marta Stanzani, 11 Antonella Ferrari, 12 Bruno Martino, 13 Lorella Melillo, 14 Gianpaolo Nadali, 15 Edoardo Simonetti, 16 Stelvio Ballanti, 16 Marco Picardi, 17 …”

Frequency Rate of Oral Candidiasis Among Patients on Oncology Management at Khartoum Isotope and Radiation Teaching Hospital.

“…The higher prevalence of oral candidiasis was found among the age group (34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52) year followed by the age group 53-72 years. This may be due to the fact that, the most cancer patients were occupaied in this group, as reported by 2607 study, [35] that the higher incidence cases of cancer were recorded among Khartoum residents in 2009-2010 were between 25-54 years.…”

“…It is well known that cancer and chemotherapy result in immunosuppression which gives opportunity for emergence of Candida infection. The outcome is the immune dysfunction and mucosal damage which promote yeast infections such as mucositis, xerostomia and candidiasis [38,39]. It is well known that prolonged use of chemotherapy may lead to neutropenia, disruption of mucosal barrier and overall damage to cell mediated immunity which increases the risk of infection.…”