Incidence, etiology and timing of infections following azacitidine therapy for myelodysplastic syndromes

被引：31

作者：

Trubiano, Jason A. ^{[1
,2
]}

Dickinson, Michael ^{[3
]}

Thursky, Karin A. ^{[1
,2
]}

Spelman, Timothy ^{[2
]}

Seymour, John F. ^{[2
]}

Slavin, Monica A. ^{[1
,2
,4
]}

Worth, Leon J. ^{[1
,2
]}

机构：

[1] Peter MacCallum Canc Ctr, Dept Infect Dis, St Andrews Pl, East Melbourne, Vic 3002, Australia

[2] Univ Melbourne, Dept Med, Melbourne, Vic, Australia

[3] Peter MacCallum Canc Ctr, Dept Haematol, East Melbourne, Australia

[4] Royal Melbourne Hosp, Peter Doherty Inst, Victorian Infect Dis Serv, Melbourne, Vic, Australia

来源：

LEUKEMIA & LYMPHOMA | 2017年 / 58卷 / 10期

关键词：

Azacitidine; myelodysplastic syndrome; infection; invasive fungal disease; complications; CONVENTIONAL CARE REGIMENS; PROGNOSTIC SCORING SYSTEM; STEM-CELL TRANSPLANTATION; ACUTE MYELOID-LEUKEMIA; PROPHYLAXIS; METAANALYSIS; DISEASE; TRIALS; CANCER;

D O I：

10.1080/10428194.2017.1295141

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

We examine the infective complications occurring during azacitidine (AZA) therapy in patients with myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML). A retrospective review of patients receiving >= 1 cycle of AZA for MDS or AML was performed. Patient demographics, infection prophylaxis/episodes and outcomes were evaluated. Sixty eight patients received 884 AZA cycles. Bacterial infections occurred in 25% of cycle-1 and 27% of cycle-2 AZA therapy. Febrile neutropenia complicated 5.3% of AZA cycles, bacteremia 2% and invasive Aspergillosis 0.3%. Using Poisson modeling, a very high IPSS-R (RR 10.26, 95% CI 1.20, 87.41, p=.033) was identified as an independent risk factor for infection. Infection-related attributable mortality was 23%. The burden of infection is high in AZA-treated patients, associated with high attributable mortality. Over 25% of AZA cycles 1 and 2 were complicated by infection, predominantly bacterial, rates dropping to <10% after cycle-5.

引用

页码：2379 / 2386

页数：8

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