Invasive aspergillosis increase the risk of death in acute myeloid leukaemia patients

M. Michallet, S. Kraghel, T. Benet, M. Sobh, M. El Hamri, G. Cannas, F. Nicolini, E. Nicolas-Virelizier, H. Labussiere, S. Ducastelle, R. Crocchiolo, F. Barraco, X. Thomas, Y. Chelghoum, M. Nicolle, A. Bienvenu, F. Persat, F. De Monbrison, N

Author address: 

Hôpital Edouard Herriot (Lyon, FR)

Abstract: 

Objectives: To study the impact of invasive aspergillosis (IA) incidence during induction therapy for acute myeloid leukemia (AML) patients on short and long term overall survival. Methods: A retrospective cohort study was performed in the Hematology department of the Edouard Herriot Hospital, Lyon (France). Patients with newly diagnosed AML between S392 01/01/2004 and 31/12/2007 were retrospectively included and the follow-up was censored at 30/06/2009. Data were extracted from medical charts and from the prospective surveillance of IA (EORTC diagnosis criteria). The patients with IA after post induction evaluation were excluded (N = 5). A Cox proportional hazard model with diagnosis of IA and post induction evaluation (complete remission [CR] of AML or failure of chemotherapy) as the main exposure besides age, year of inclusion, WHO status, cytogenetic group, kind of induction chemotherapy, and hematopoietic stem cell transplantation, was fi tted. Results: Overall, 262 patients counting for 149 370 patientdays were analysed, the median age at diagnosis was 56.6 years (47.9-64.2 years), and 196 (75%) had CR. There were 58 (22%) IA cases with a median interval between induction and IA of 30 days (range, 16-27 days); 29 (50%) IA were possible, 24 (41%) probable, and 5 (9%) proven. At the last followup, 165 (63%) patients died with a median overall survival of 18 months (95% confi dence interval [95% CI] 14-23 months). The 4 year-survival of patients having had IA was 14%, and without IA 32% (P = 0.01). The 2 year-survival of patients achieving of CR was 54% vs. 5% for patients with failure of chemotherapy was 5% (P
2010

abstract No: 

R1268

Full conference title: 

Annual Meeting of the EBMT, 36th
    • EBMT 36th (2010)