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)

被引：69

作者：

Caira, Morena ^{[1
]}

Candoni, Anna ^{[2
]}

Verga, Luisa ^{[3
]}

Busca, Alessandro ^{[4
]}

Delia, Mario ^{[5
]}

Nosari, Annamaria ^{[6
,7
]}

Caramatti, Cecilia ^{[8
]}

Castagnola, Carlo ^{[9
]}

Cattaneo, Chiara ^{[10
]}

Fanci, Rosa ^{[11
,12
]}

Chierichini, Anna ^{[13
]}

Melillo, Lorella ^{[14
]}

Mitra, Maria Enza ^{[15
]}

Picardi, Marco ^{[16
]}

Potenza, Leonardo ^{[17
]}

Salutari, Prassede ^{[18
]}

Vianelli, Nicola ^{[19
]}

Facchini, Luca ^{[20
]}

Cesarini, Monica ^{[1
]}

De Paolis, Maria Rosaria ^{[21
]}

Di Blasi, Roberta ^{[1
]}

Farina, Francesca ^{[3
]}

Venditti, Adriano ^{[22
]}

Ferrari, Antonella ^{[23
]}

Garzia, Mariagrazia ^{[24
]}

Gasbarrino, Cristina ^{[25
]}

Invernizzi, Rosangela ^{[26
]}

Lessi, Federica ^{[27
]}

Manna, Annunziata ^{[28
]}

Martino, Bruno ^{[29
]}

Nadali, Gianpaolo ^{[30
]}

Offidani, Massimo ^{[31
]}

Paris, Laura ^{[6
,7
]}

Pavone, Vincenzo ^{[32
]}

Rossi, Giuseppe ^{[10
]}

Spadea, Antonio ^{[33
]}

Specchia, Giorgina ^{[5
]}

Trecarichi, Enrico Maria ^{[34
]}

Vacca, Adriana ^{[35
]}

Cesaro, Simone ^{[36
]}

Perriello, Vincenzo ^{[37
]}

Aversa, Franco ^{[8
]}

Tumbarello, Mario ^{[34
]}

Pagano, Livio ^{[1
]}

机构：

[1] Univ Cattolica Sacro Cuore, Ist Ematol, Rome, Italy

[2] Azienda Osped Univ Udine, Clin Ematol, Udine, Italy

[3] Univ Milano Bicocca, Osped S Gerardo, Unita Ematol, Monza, Italy

[4] AO Citta Salute & Sci, SC Ematol, Turin, Italy

[5] Univ Bari, Azienda Osped Univ Consorziale Policlin Bari, Dept Emergency & Organ Transplantat, Hematol & BMT Unit, I-70121 Bari, Italy

[6] Osped Niguarda Ca Granda, Div Ematol, Milan, Italy

[7] Osped Niguarda Ca Granda, Ctr Trapianti Midollo, Milan, Italy

[8] Univ Parma, Sez Ematol, I-43100 Parma, Italy

[9] Fdn ICRRS Policlin San Matteo, Dipartimento Oncoematol, Pavia, Italy

[10] Spedali Civili Brescia, Div Ematol, Brescia, Italy

[11] Azienda Osped Univ Careggi, Unita Funz Ematol, Careggi, Italy

[12] Univ Florence, I-50121 Florence, Italy

[13] Azienda Osped S Giovanni Addolorata, UOC Ematol, Rome, Italy

[14] IRCCS Casa Sollievo Sofferenza, Unita Ematol, San Giovanni Rotondo, Italy

[15] Policlin Palermo, Div Ematol & TMO, Palermo, Italy

[16] Azienda Osped Univ Federico II Napoli, Dipartimento Med Clin & Chirurg, Naples, Italy

[17] Univ Modena & Reggio Emilia, Sez Ematol, Dipartimento Sci Med & Chirurg Maternoinfantili &, Modena, Italy

[18] Osped Santo Spirito, Dipartimento Ematol Clin, Pescara, Italy

[19] Univ Bologna, Osped S Orsola Malpighi, Ist Ematol & Oncol Clin Lorenzo & Ariosto Seragno, I-40126 Bologna, Italy

[20] Arciosped S Maria Nuova, Div Ematol, Reggio Emilia, Italy

[21] Osped Lecce, Dipartimento Ematol, Lecce, Italy

[22] Univ Roma Tor Vergata, Dipartimento Biomed & Prevenz, Ematol, Rome, Italy

[23] Osped S Andrea, Rome, Italy

[24] Osped San Camillo, Div Ematol, Rome, Italy

[25] Univ Cattolica S Cuore, Div Ematol, Campobasso, Italy

[26] Univ Pavia, Fdn IRCCS Policlin San Matteo, Dipartimento Med Interna, I-27100 Pavia, Italy

[27] Univ Padua, Dipartimento Med, Ematol & Immunol Clin, I-35100 Padua, Italy

[28] Osped La Spezia, Unita Complessa Oncoematol, La Spezia, Italy

[29] Azienda Osped Bianchi Melacrino Morelli, Div Ematol, Reggio Di Calabria, Italy

[30] Azienda Osped Univ Integrata Verona, UOC Ematol, Verona, Italy

[31] Univ Ancona, Clin Ematol, I-60128 Ancona, Italy

[32] Osped Tricase, Clin Ematol, Tricase, Italy

[33] Ist Fisioterap Ospitalieri, Unita Ematol, Rome, Italy

[34] Univ Cattolica Sacro Cuore, Ist Malattie Infett, Rome, Italy

[35] Ematol CTMO Osped Roberto Binaghi Cagliari, Cagliari, Italy

[36] Azienda Osped Univ Integrata, Ematooncol Pediat, Verona, Italy

[37] Univ Perugia, Osped S Maria della Misericordia, Ist Ematol, I-06100 Perugia, Italy

来源：

HAEMATOLOGICA | 2015年 / 100卷 / 02期

关键词：

PULMONARY ASPERGILLOSIS; MOLD INFECTIONS; CIGARETTE-SMOKE; EPIDEMIOLOGY; POSACONAZOLE; PROPHYLAXIS; MORTALITY; IMPACT; NEUTROPENIA; FLUCONAZOLE;

D O I：

10.3324/haematol.2014.113399

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：284 / 292

页数：9

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