TY - JOUR
T1 - Invasive aspergillosis in patients with acute myeloid leukemia: SEIFEM-2008 registry study.
AU - Pagano, Livio
AU - Caira, Morena
AU - Candoni, Anna
AU - Offidani, Massimo
AU - Martino, Bruno
AU - Specchia, Giorgina
AU - Pastore, Domenico
AU - Stanzani, Marta
AU - Cattaneo, Chiara
AU - Fanci, Rosa
AU - Caramatti, Cecilia
AU - Rossini, Fausto
AU - Luppi, Mario
AU - Potenza, Leonardo
AU - Ferrara, Felicetto
AU - Mitra, Maria Enza
AU - Fadda, Rafaela Maria
AU - Invernizzi, Rosangela
AU - Aloisi, Teresa
AU - Picardi, Marco
AU - Bonini, Alessandro
AU - Vacca, Adriana
AU - Chierichini, Anna
AU - Melillo, Lorella
AU - De Waure, Chiara
AU - Fianchi, Luana
AU - Riva, Marta
AU - Leone, Giuseppe
AU - Aversa, Franco
AU - Nosari, Annamaria
PY - 2009
Y1 - 2009
N2 - 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.
AB - 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.
KW - Aspergillosis
KW - Aspergillosis
UR - http://hdl.handle.net/10807/3808
M3 - Article
SN - 0390-6078
VL - 2010
SP - 644
EP - 650
JO - Haematologica
JF - Haematologica
ER -