Infectious complications in adult acute myeloid leukemia: analysis of the Acute Leukemia French Association-9802 prospective multicenter clinical trial

被引:47
作者
Cannas, Giovanna [1 ]
Pautas, Cecile [2 ]
Raffoux, Emmanuel [3 ]
Quesnel, Bruno [4 ]
de Botton, Stephane [5 ]
de Revel, Thierry [6 ]
Reman, Oumedaly [7 ]
Gardin, Claude [8 ]
Elhamri, Mohamed [1 ]
Boissel, Nicolas [3 ]
Fenaux, Pierre [8 ]
Michallet, Mauricette [1 ]
Castaigne, Sylvie [9 ]
Dombret, Herve [3 ]
Thomas, Xavier [1 ]
机构
[1] Hosp Civils Lyon, Hop Edouard Herriot, Dept Hematol, F-69437 Lyon, France
[2] Hop Henri Mondor, Dept Hematol, F-94010 Creteil, France
[3] Hop St Louis, Dept Hematol, Paris, France
[4] Hop Claude Huriez, Dept Hematol, Lille, France
[5] Inst Gustave Roussy, Dept Hematol, Villejuif, France
[6] Hop Armees Percy, Dept Hematol, Clamart, France
[7] Hop Georges Clemenceau, Dept Hematol, Caen, France
[8] Hop Avicenne, Dept Hematol, F-93009 Bobigny, France
[9] Hop Andre Mignot, Dept Hematol, Versailles, France
关键词
Acute myeloid leukemia; infection; prognosis; chemotherapy; aspergillosis; INVASIVE FUNGAL-INFECTIONS; STEM-CELL TRANSPLANTS; NEUTROPENIC PATIENTS; HEMATOLOGICAL MALIGNANCIES; BACTERIAL-INFECTION; CANCER-PATIENTS; AMPHOTERICIN-B; CHEMOTHERAPY; PROPHYLAXIS; VORICONAZOLE;
D O I
10.3109/10428194.2011.636812
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Infections are a major complication in patients with acute myeloid leukemia undergoing intensive chemotherapy. They remain a major cause of therapy-associated morbidity and mortality, and represent a frequent cause of treatment withdrawal. An analysis of the medical charts of 459 younger adults included in the multicenter Acute Leukemia French Association (ALFA)-9802 trial showed that 1369 febrile episodes occurred among the 459 registered patients, including fever without identifiable source (23%) and clinically or microbiologically documented infections (77%). Bloodstream infections occurred in 314 episodes, including 129 documented episodes with Gram-positive and 96 with Gram-negative pathogens. Pulmonary infection was diagnosed in 144/1054 documented infectious episodes (14%). Invasive fungal infection was probable or proven in 116 patients. In all, 15 patients died of infection-associated complications, of whom seven died during early induction therapy, one during salvage therapy and seven during consolidation therapy. Better supportive care strategies may improve overall survival in patients undergoing chemotherapy for acute myeloid leukemia.
引用
收藏
页码:1068 / 1076
页数:9
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