Incidence of invasive fungal infection in acute lymphoblastic and acute myelogenous leukemia in the era of antimold prophylaxis

Abstract The incidence of invasive fungal infection (IFI) in patients with acute myeloid leukemia (AML) has decreased with the introduction of antimold prophylaxis. Although acute lymphoblastic leukemia (ALL) has a lower risk of IFI than does AML, the incidences of IFI in both AML and ALL in the era...

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Autores principales:	Sang-Min Oh, Ja Min Byun, Euijin Chang, Chang Kyung Kang, Dong-Yeop Shin, Youngil Koh, Junshik Hong, Taek Soo Kim, Pyoeng Gyun Choe, Wan Beom Park, Nam Joong Kim, Sung-Soo Yoon, Inho Kim, Myoung-don Oh
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/31e514d7d0d84e6e9e96856da92679ac
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spelling	oai:doaj.org-article:31e514d7d0d84e6e9e96856da92679ac2021-11-14T12:17:56ZIncidence of invasive fungal infection in acute lymphoblastic and acute myelogenous leukemia in the era of antimold prophylaxis10.1038/s41598-021-01716-22045-2322https://doaj.org/article/31e514d7d0d84e6e9e96856da92679ac2021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01716-2https://doaj.org/toc/2045-2322Abstract The incidence of invasive fungal infection (IFI) in patients with acute myeloid leukemia (AML) has decreased with the introduction of antimold prophylaxis. Although acute lymphoblastic leukemia (ALL) has a lower risk of IFI than does AML, the incidences of IFI in both AML and ALL in the era of antimold prophylaxis should be re-evaluated. We analyzed adults with AML or ALL who had undergone induction, re-induction, or consolidation chemotherapy from January 2017 to December 2019 at Seoul National University Hospital. Their clinical characteristics during each chemotherapy episode were reviewed, and cases with proven or probable diagnoses were regarded as positive for IFI. Of 552 episodes (393 in AML and 159 in ALL), 40 (7.2%) were IFI events. Of the IFI episodes, 8.1% (12/148) and 5.9% (13/220) (P = 0.856) occurred in cases of ALL without antimold prophylaxis and AML with antimold prophylaxis, respectively. After adjusting for clinical factors, a lack of antimold prophylaxis (adjusted odds ratio [aOR], 3.52; 95% confidence interval [CI], 1.35–9.22; P = 0.010) and a longer duration of neutropenia (per one day, aOR, 1.02; 95% CI, 1.01–1.04; P = 0.001) were independently associated with IFI. In conclusion, the incidence of IFI in ALL without antimold prophylaxis was not lower than that in AML. A lack of antimold prophylaxis and prolonged neutropenia were independent risk factors for IFI. Clinicians should be on guard for detecting IFI in patients with ALL, especially those with risk factors.Sang-Min OhJa Min ByunEuijin ChangChang Kyung KangDong-Yeop ShinYoungil KohJunshik HongTaek Soo KimPyoeng Gyun ChoeWan Beom ParkNam Joong KimSung-Soo YoonInho KimMyoung-don OhNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sang-Min Oh Ja Min Byun Euijin Chang Chang Kyung Kang Dong-Yeop Shin Youngil Koh Junshik Hong Taek Soo Kim Pyoeng Gyun Choe Wan Beom Park Nam Joong Kim Sung-Soo Yoon Inho Kim Myoung-don Oh Incidence of invasive fungal infection in acute lymphoblastic and acute myelogenous leukemia in the era of antimold prophylaxis
description	Abstract The incidence of invasive fungal infection (IFI) in patients with acute myeloid leukemia (AML) has decreased with the introduction of antimold prophylaxis. Although acute lymphoblastic leukemia (ALL) has a lower risk of IFI than does AML, the incidences of IFI in both AML and ALL in the era of antimold prophylaxis should be re-evaluated. We analyzed adults with AML or ALL who had undergone induction, re-induction, or consolidation chemotherapy from January 2017 to December 2019 at Seoul National University Hospital. Their clinical characteristics during each chemotherapy episode were reviewed, and cases with proven or probable diagnoses were regarded as positive for IFI. Of 552 episodes (393 in AML and 159 in ALL), 40 (7.2%) were IFI events. Of the IFI episodes, 8.1% (12/148) and 5.9% (13/220) (P = 0.856) occurred in cases of ALL without antimold prophylaxis and AML with antimold prophylaxis, respectively. After adjusting for clinical factors, a lack of antimold prophylaxis (adjusted odds ratio [aOR], 3.52; 95% confidence interval [CI], 1.35–9.22; P = 0.010) and a longer duration of neutropenia (per one day, aOR, 1.02; 95% CI, 1.01–1.04; P = 0.001) were independently associated with IFI. In conclusion, the incidence of IFI in ALL without antimold prophylaxis was not lower than that in AML. A lack of antimold prophylaxis and prolonged neutropenia were independent risk factors for IFI. Clinicians should be on guard for detecting IFI in patients with ALL, especially those with risk factors.
format	article
author	Sang-Min Oh Ja Min Byun Euijin Chang Chang Kyung Kang Dong-Yeop Shin Youngil Koh Junshik Hong Taek Soo Kim Pyoeng Gyun Choe Wan Beom Park Nam Joong Kim Sung-Soo Yoon Inho Kim Myoung-don Oh
author_facet	Sang-Min Oh Ja Min Byun Euijin Chang Chang Kyung Kang Dong-Yeop Shin Youngil Koh Junshik Hong Taek Soo Kim Pyoeng Gyun Choe Wan Beom Park Nam Joong Kim Sung-Soo Yoon Inho Kim Myoung-don Oh
author_sort	Sang-Min Oh
title	Incidence of invasive fungal infection in acute lymphoblastic and acute myelogenous leukemia in the era of antimold prophylaxis
title_short	Incidence of invasive fungal infection in acute lymphoblastic and acute myelogenous leukemia in the era of antimold prophylaxis
title_full	Incidence of invasive fungal infection in acute lymphoblastic and acute myelogenous leukemia in the era of antimold prophylaxis
title_fullStr	Incidence of invasive fungal infection in acute lymphoblastic and acute myelogenous leukemia in the era of antimold prophylaxis
title_full_unstemmed	Incidence of invasive fungal infection in acute lymphoblastic and acute myelogenous leukemia in the era of antimold prophylaxis
title_sort	incidence of invasive fungal infection in acute lymphoblastic and acute myelogenous leukemia in the era of antimold prophylaxis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/31e514d7d0d84e6e9e96856da92679ac
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Incidence of invasive fungal infection in acute lymphoblastic and acute myelogenous leukemia in the era of antimold prophylaxis

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