Invasive aspergillosis in patients with acute myeloid leukemia: SEIFEM-2008 registry study.

Livio Pagano, Morena Caira, Anna Candoni, Massimo Offidani, Bruno Martino, Giorgina Specchia, Domenico Pastore, Marta Stanzani, Chiara Cattaneo, Rosa Fanci, Cecilia Caramatti, Fausto Rossini, Mario Luppi, Leonardo Potenza, Felicetto Ferrara, Maria Enza Mitra, Rafaela Maria Fadda, Rosangela Invernizzi, Teresa Aloisi, Marco PicardiAlessandro Bonini, Adriana Vacca, Anna Chierichini, Lorella Melillo, Chiara De Waure, Luana Fianchi, Marta Riva, Giuseppe Leone, Franco Aversa, Annamaria Nosari

Research output: Contribution to journalArticle

Abstract

Background The aim of this study was to evaluate prognostic factors, treatments and outcome of invasive aspergillosis in patients with acute myeloid leukemia based on data collected in a registry. Design and Methods The registry, which was activated in 2004 and closed in 2007, collected data on patients with acute myeloid leukemia, admitted to 21 hematologic divisions in tertiary care centers or university hospitals in Italy, who developed proven or probable invasive aspergillosis. Results One hundred and forty cases of invasive aspergillosis were collected, with most cases occurring during the period of post-induction aplasia, the highest risk phase in acute myeloid leukemia. The mortality rate attributable to invasive aspergillosis was 27%, confirming previous reports of a downward trend in this rate. Univariate and multivariate analyses revealed that the stage of acute myeloid leukemia and the duration of, and recovery from, neutropenia were independent prognostic factors. We analyzed outcomes after treatment with the three most frequently used drugs (liposomal amphotericin B, caspofungin, voriconazole). No differences emerged in survival at day 120 or in the overall response rate which was 71%, ranging from 61% with caspofungin to 84% with voriconazole. Conclusions Our series confirms the downward trend in mortality rates reported in previous series, with all new drugs providing similar survival and response rates. Recovery from neutropenia and disease stage are crucial prognostic factors. Efficacious antifungal drugs bridge the period of maximum risk due to poor hematologic and immunological reconstitution.
Original languageEnglish
Pages (from-to)644-650
Number of pages7
JournalHaematologica
Volume2010
Publication statusPublished - 2009

Keywords

  • Aspergillosis

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