The Spectrum of Fungal Infections in Patients with Haematological Malignancies in the Last 5 Years: Royal Marsden Experience

B. SIROHI, R. POWLES, S. KULKARNI, U. RILEY

Author address: 

Royal Marsden NHS Trust, Sutton, United Kingdom

Abstract: 

Background: Incidence of fungal infections has increased as intensity of chemotherapy and subsequent depth and length of neutropenia has increased. Methods: From a prospectively maintained database, we identified 421 patients with AML/MDS- 152; ALL-54; Myeloma- 180, others- 35; who received 535 courses of i/v antifungal therapy (AFT) during course of their treatment. Results:Median age of patients was 48 years (14-77; 149 F, 272 M). Patients received AFT after allogeneic (n=115) or autotransplantation (n=217) /chemotherapy (n=203). Median neutrophils at start of AFT was 0 (0-31.2) and median baseline creatinine was 80micmol/L(33-728). Patients were categorised to have suspected (n=489), probable (n=21) or proven (n=25) fungal infection. Out of 46/535 (9%) probable /proven infections, 37 (80%) patients had invasive pulmonary aspergillosis (IPA- 21 probable, 16 proven A fumigatus) for which they were treated with ambisome 3-5mg/kg/ abelcet 5mg/kg/ amphocil 4mg/kg. Overall response rate was 23/37 (62%; 12 complete, 11 partial) ;12 patients had a fungal death; 2 patients died of disease and MI. The 9 other proven infections were fungaemia with C.albicans (n=2), A. niger (n=2), T. beigellii (n=1), C. neoformans (n=1), C.glabrata (n=1; blood), C. krusei (n=1) & Fusarium (n=1); there were 5 fungal deaths, 3 complete & 1 partial response. The median time from treatment to start chemotherapy was 14d while the patients were on AFT from 1-110d (median 9). Patients with allografts/autografts (P=0.0001), ANC
2001

abstract No: 

NULL

Full conference title: 

ICAAC 41st
    • ICAAC 41st