TY - JOUR
T1 - Pre-chemotherapy risk factors for invasive fungal diseases: prospective analysis of 1,192 patients with newly diagnosed acute myeloid leukemia (SEIFEM 2010-a multicenter study)
AU - Pagano, Livio
AU - Tumbarello, Mario
AU - Candoni, Anna
AU - Verga, Luisa
AU - Busca, Alessandro
AU - Delia, Mario
AU - Nosari, Annamaria
AU - Caramatti, Cecilia
AU - Castagnola, Carlo
AU - Cattaneo, Chiara
AU - Fanci, Rosa
AU - Chierichini, Anna
AU - Melillo, Lorella
AU - Mitra, Maria Enza
AU - Picardi, Marco
AU - Potenza, Leonardo
AU - Salutari, Prassede
AU - Vianelli, Nicola
AU - Facchini, Luca
AU - De Paolis, Maria Rosaria
AU - Farina, Francesca
AU - Venditti, Adriano
AU - Ferrari, Antonella
AU - Garzia, Mariagrazia
AU - Invernizzi, Rosangela
AU - Lessi, Federica
AU - Manna, Annunziata
AU - Martino, Bruno
AU - Nadali, Gianpaolo
AU - Offidani, Massimo
AU - Paris, Laura
AU - Pavone, Vincenzo
AU - Rossi, Giuseppe
AU - Spadea, Antonio
AU - Specchia, Giorgina
AU - Vacca, Adriana
AU - Cesaro, Simone
AU - Perriello, Vincenzo
AU - Ragionieri, Riccardo
AU - Orsola-Malpighi, Ospedale S.
AU - Antoniazzi, Francesca
AU - Luppi, Mario
AU - Pagliuca, Simona
AU - Rossetti, Elena
AU - Da Vià, Matteo
AU - Di Caprio, Luigi
AU - Majolino, Ignazio
AU - Cascavilla, Nicola
AU - Turri, Gloria
AU - Fanin, Renato
PY - 2015
Y1 - 2015
N2 - Correct definition of the level of risk of invasive fungal infections is the first step in improving the targeting of preventive strategies. We investigated the potential relationship between pre-hospitalization exposure to sources of fungi and the development of invasive fungal infections in adult patients with newly diagnosed acute myeloid leukemia after their first course of chemotherapy. From January 2010 to April 2012, all consecutive acute myeloid leukemia patients in 33 Italian centers were prospectively registered. Upon first admission, information about possible pre-chemotherapy risk factors and environmental exposure was collected. We recorded data regarding comorbid conditions, employment, hygienic habits, working and living environment, personal habits, hobbies, and pets. All invasive fungal infections occurring within 30 days after the first course of chemotherapy were recorded. Of the 1,192 patients enrolled in this study, 881 received intensive chemotherapy and were included in the present analysis. Of these, 214 developed an invasive fungal infection, including 77 proven/probable cases (8.7%). Of these 77 cases, 54 were proven/probable invasive mold infections (6.1%) and 23 were proven yeast infections (2.6%). Upon univariate analysis, a significant association was found between invasive mold infections and age, performance status, diabetes, chronic obstructive pulmonary disease, smoking, cocaine use, job, hobbies, and a recent house renovation. Higher body weight resulted in a reduced risk of invasive mold infections. Multivariate analysis confirmed the role of performance status, job, body weight, chronic obstructive pulmonary disease, and house renovation. In conclusion, several hospital-independent variables could potentially influence the onset of invasive mold infections in patients with acute myeloid leukemia. Investigation of these factors upon first admission may help to define a patient's risk category and improve targeted prophylactic strategies.
AB - Correct definition of the level of risk of invasive fungal infections is the first step in improving the targeting of preventive strategies. We investigated the potential relationship between pre-hospitalization exposure to sources of fungi and the development of invasive fungal infections in adult patients with newly diagnosed acute myeloid leukemia after their first course of chemotherapy. From January 2010 to April 2012, all consecutive acute myeloid leukemia patients in 33 Italian centers were prospectively registered. Upon first admission, information about possible pre-chemotherapy risk factors and environmental exposure was collected. We recorded data regarding comorbid conditions, employment, hygienic habits, working and living environment, personal habits, hobbies, and pets. All invasive fungal infections occurring within 30 days after the first course of chemotherapy were recorded. Of the 1,192 patients enrolled in this study, 881 received intensive chemotherapy and were included in the present analysis. Of these, 214 developed an invasive fungal infection, including 77 proven/probable cases (8.7%). Of these 77 cases, 54 were proven/probable invasive mold infections (6.1%) and 23 were proven yeast infections (2.6%). Upon univariate analysis, a significant association was found between invasive mold infections and age, performance status, diabetes, chronic obstructive pulmonary disease, smoking, cocaine use, job, hobbies, and a recent house renovation. Higher body weight resulted in a reduced risk of invasive mold infections. Multivariate analysis confirmed the role of performance status, job, body weight, chronic obstructive pulmonary disease, and house renovation. In conclusion, several hospital-independent variables could potentially influence the onset of invasive mold infections in patients with acute myeloid leukemia. Investigation of these factors upon first admission may help to define a patient's risk category and improve targeted prophylactic strategies.
KW - leukemia
KW - leukemia
UR - http://hdl.handle.net/10807/65162
U2 - 10.3324/haematol.2014.113399
DO - 10.3324/haematol.2014.113399
M3 - Article
VL - 100
SP - 284
EP - 292
JO - Haematologica
JF - Haematologica
SN - 0390-6078
ER -