Risk factors for invasive fungal infections in acute myeloid leukaemia patients during primary antifungal prophylaxis at M.D. Anderson Cancer Center, 2009-2011

Ref ID: 19210


M. Gomes*, V. Mulanovich, J. Ying, R. Lewis, D. Kontoyiannis

Author address:

Houston, US

Full conference title:

23rd European Congress of Clinical Microbiology and
Infectious Diseases

Date: 27 April 2014


Objectives: We aimed to investigate risk factors for documented (definite or probable, according to revised EORTC definitions) invasive fungal infections (IFIs) in acute myeloid leukemia (AML) patients. Methods: We conducted a nested case-control study in a cohort of 165 patients older than 18 years old newly diagnosed with AML who received primary antifungal prophylaxis (PAP) during 120 days after first induction chemotherapy in M.D. Anderson Cancer Center from August 2009 to March 2011. We excluded patients who underwent stem cell transplant (13 patients), were never admitted to the hospital (4 patients), used fluconazole only as PAP (12 patients) or those who had presumed IFI (13 patients) during the study period. We found 21 patients with documented IFI (4 definite mold and 4 yeast infections, 1 coccidioidomycosis and 12 probable invasive aspergillosis) (case group). The control group included 104 patients without an IFI. Variables investigated as factors associated with IFI were gathered from the period prior to the date that IFI was first detected in case patients or as the entire period of following up for the control patients. Thirty and 21 variables were investigated as risk factors at 120 and 42 days study period, respectively. Results: The Table shows the Cox regression models for IFIs with PAP drug, neutropenia and complete remission as time-dependent variables in the analyses at 42 and 120 day-study period. Conclusions: This retrospective single center study indicates that patients with therapy related AML should be more closely monitored for IFI. Echinocandin-based PAP should be avoided or used with caution in AML population. Further studies should evaluate the relevance and biologic plausibility of appendectomy for IFI risk in leukemia.

Abstract Number: P1002

Conference Year: 2013

Link to conference website: http://registration.akm.ch/einsicht.php?XNABSTRACT_ID=167284&XNSPRACHE_ID=2&XNKONGRESS_ID=180&XNMASK

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