2021
DOI: 10.1111/ejh.13631
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Risk factors for invasive fungal infection in 5‐azacytidine treated patients with acute myeloid leukemia and myelodysplastic syndrome

Abstract: 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‐azacyt… Show more

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Cited by 7 publications
(3 citation statements)
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“…On the strength of these data, the European Conference on Infections in Leukaemia (ECIL) does not recommend antifungal prophylaxis in patients with low-to-intermediate risk MDS receiving HMAs (AZA or DAC) ( Maertens et al., 2018 ). Due to the scant available data for AML patients who are elderly or have co-existing diseases, HMA regimens are deemed appropriate instead of standard chemotherapy for such patients ( Tey et al., 2021 ). In our study, the choice of antifungal prophylaxis was at the discretion of the treating physician, according to the patient’s clinical condition.…”
Section: Discussionmentioning
confidence: 99%
“…On the strength of these data, the European Conference on Infections in Leukaemia (ECIL) does not recommend antifungal prophylaxis in patients with low-to-intermediate risk MDS receiving HMAs (AZA or DAC) ( Maertens et al., 2018 ). Due to the scant available data for AML patients who are elderly or have co-existing diseases, HMA regimens are deemed appropriate instead of standard chemotherapy for such patients ( Tey et al., 2021 ). In our study, the choice of antifungal prophylaxis was at the discretion of the treating physician, according to the patient’s clinical condition.…”
Section: Discussionmentioning
confidence: 99%
“…Because there was no significant difference between our AML patient cohorts with respect to the percentage of de novo AML or hematological malignancies prior to AML diagnosis, respectively, we did not perform subgroup analysis focusing on this potential factor. [50,51] In contrast, we could demonstrate a high rate of atypical pneumonia including a significantly higher proportion of pulmonary IFD in AML patients following induction chemotherapy. Several factors might contribute to the high incidence of pulmonary IFD in this well-defined cohort of AML patients: 1 st , ANC are extremely low in AML patients undergoing induction chemotherapy; 2 nd , the duration of severe neutropenia (ANC < 500 per µl); 3 rd , the treatment-associated toxicity of conventional chemotherapy.…”
Section: Discussionmentioning
confidence: 66%
“…Another potential factor for preexisting pneumonia at AML diagnosis might be attributed to an impaired function of innate immunity (e.g., in patients with antecedent MDS). Because there was no significant difference between our AML patient cohorts with respect to the percentage of de novo AML or hematological malignancies prior to AML diagnosis, respectively, we did not perform subgroup analysis focusing on this potential factor (Tey et al 2021;Andréa et al 2012).…”
Section: Discussionmentioning
confidence: 99%