Invasive aspergillosis in relapsed/refractory acute myeloid leukaemia patients: Results from SEIFEM 2016-B survey

Livio Pagano, Giulia Dragonetti, Maria Ilaria Del Principe, Allegra Conti, Luisa Verga, Stelvio Ballanti, Rosa Fanci, Anna Candoni, Francesco Marchesi, Chiara Cattaneo, Federica Lessi, Nicola Fracchiolla, Angelica Spolzino, Lucia Prezioso, Mario Delia, Leonardo Potenza, Nunzia Decembrino, Carlo Castagnola, Gianpaolo Nadali, Marco PicardiDaniele Zama, Enrico Orciulo, Barbara Veggia, Mariagrazia Garzia, Michelina Dargenio, Lorella Melillo, Sara Manetta, Domenico Russo, Valentina Mancini, Monica Piedimonte, Maria Chiara Tisi, Nicola Toschi, Alessandro Busca

Risultato della ricerca: Contributo in rivistaAbstract

Abstract

Background: In patients with relapsed/refractory acute myeloid leukaemia (R/R AML) who received salvage chemotherapy, limited and not updated studies explored the incidence of invasive aspergillosis (IA) and the role of antifungal prophylaxis (AP). The aims of this multicentre retrospective ‘SEIFEM 2016-B’ study were as follows: (1) to evaluate the current rate and the outcome of proven/probable IA and (2) to assess the efficacy of AP, in a large ‘real life’ series of patient with R/R AML submitted to salvage chemotherapy. Results: Of 2250 R/R AML patients, a total of 74 cases of IA (5.1%) were recorded as follows: 10 (0.7%) proven and 64 (4.3%) probable. Information about AP were available in 73/74 (99%) patients. Fifty-eight (79%) breakthrough infections occurred, mainly during AP with posaconazole [25 (43%)]. The patients who received AP during salvage chemotherapy showed a benefit from antifungal therapy (AT) than patients who did not received AP [43 (86%) vs 7 (14%); p <.033]. In a multivariate analysis, AP and absence of severe mucositis had a significant favourable effect on overall response rate. Conclusion: Our data demonstrated that the incidence of IA during the salvage chemotherapy is similar to the past. Nevertheless, the attributable mortality rate (AMR) appears to be lower than that previously reported in R/R AML. Further prospective studies should be performed to confirm our preliminary observation and understand and the why a decreased AMR is reported in this setting of high-risk patients.
Lingua originaleEnglish
pagine (da-a)171-177
Numero di pagine7
RivistaMycoses
Volume65
DOI
Stato di pubblicazionePubblicato - 2022

Keywords

  • antifungal prophylaxis
  • antifungal therapy
  • breakthrough infections
  • invasive aspergillosis
  • posaconazole
  • refractory acute myeloid leukaemia
  • Leukemia, Myeloid, Acute
  • salvage chemotherapy
  • Humans
  • Retrospective Studies
  • Antifungal Agents
  • Aspergillosis
  • Invasive Fungal Infections
  • relapsed acute myeloid leukaemia

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