Invasive fungal diseases in patients with acute lymphoid leukemia

被引:22
作者
Nicolato, Andrea [1 ]
Nouer, Simone A. [2 ]
Garnica, Marcia [3 ]
Portugal, Rodrigo [3 ]
Maiolino, Angelo [3 ]
Nucci, Marcio [3 ]
机构
[1] Univ Fed Juiz de Fora, Univ Hosp, Dept Internal Med, Juiz De Fora, MG, Brazil
[2] Univ Fed Rio de Janeiro, Univ Hosp, Dept Prevent Med, Rio De Janeiro, Brazil
[3] Univ Fed Rio de Janeiro, Univ Hosp, Dept Internal Med, Rio De Janeiro, Brazil
关键词
Acute lymphoid leukemia; invasive fungal disease; mortality; prevalence; risk; ACUTE LYMPHOBLASTIC-LEUKEMIA; CELL TRANSPLANT RECIPIENTS; RISK-FACTORS; PULMONARY ASPERGILLOSIS; ADULT PATIENTS; INFECTIONS; CHEMOTHERAPY; OUTCOMES; EPIDEMIOLOGY; PROPHYLAXIS;
D O I
10.3109/10428194.2016.1154957
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Invasive fungal disease (IFD) represents an important complication in patients with acute lymphoid leukemia (ALL). The objectives of this study were to determine the prevalence of IFD in ALL patients with neutropenia, identify factors associated with IFD, and estimate the impact of IFD on the outcome. All patients with ALL who developed febrile neutropenia from 1987 to 2013 were evaluated. Cases of IFD were classified as proven or probable. Factors associated with IFD were evaluated by comparing episodes with and without a diagnosis of IFD. Among 350 episodes of febrile neutropenia, 31 IFDs were diagnosed (8.8%). Prolonged neutropenia was the only factor associated with IFD caused by yeasts. Factors associated with IFD caused by molds by multivariate analysis were the period after 2008, receipt of allogeneic transplant, relapsed ALL and prolonged neutropenia. Patients in relapse should receive induction chemotherapy in rooms with HEPA filter and receive antifungal prophylaxis.
引用
收藏
页码:2084 / 2089
页数:6
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