TY - JOUR
T1 - The epidemiology of fungal infections in patients with hematologic malignancies: the SEIFEM-2004 study.
AU - Pagano, Livio
AU - Caira, Morena
AU - Candoni, Anna
AU - Offidani, Masimo
AU - Fianchi, Luana
AU - Martino, Bruno
AU - Pastore, Domenico
AU - Picardi, Marco
AU - Bonini, Alessandro
AU - Chierichini, Anna
AU - Fanci, Rossella
AU - Caramatti, Cecilia
AU - Invernizzi, Rosangela
AU - Mattei, Daniele
AU - Mitra, Maria Enza
AU - Melillo, Lorella
AU - Aversa, Franco
AU - Vant Lint, Maria Teresa
AU - Falcucci, Paolo
AU - Nosari, Annamaria
AU - Valentini, Caterina Giovanna
AU - Girmenia, Corrado
AU - Nosari, Anna Maria
PY - 2006
Y1 - 2006
N2 - Background and Objectives. The aim of this study was to evaluate the incidence and
outcome of invasive fungal infections (IFI) in patients with hematologic malignancies.
Design and Methods. This was a retrospective cohort study of patients admitted
between 1999 and 2003 to 18 hematology wards in Italy. Each participating center
provided information on all patients with newly diagnosed hematologic malignancies
admitted during the survery period and on all episodes of IFI experienced by these
patients.
Results. The cohort was formed of 11,802 patients with hematologic malignacies:
acute leukemia (myeloid 3012, lymphoid 1173), chronic leukemia (myeloid 596, lymphoid
1104), lymphoma (Hodgkin’s 844, non-Hodgkin’s 3457), or multiple myeloma
(1616). There were 538 proven or probable IFI (4.6%); 373 (69%) occurred in
patients with acute myeloid leukemia. Over half (346/538) were caused by molds
(2.9%), in most cases Aspergillus spp. (310/346). The 192 yeast infections (1.6%)
included 175 cases of candidemia. Overall and IFI-attributable mortality rates were
2% (209/11802) and 39% (209/538), respectively. The highest IFI-attributable mortality
rates were associated with zygomycosis (64%) followed by fusariosis (53%),
aspergillosis (42%), and candidemia (33%).
Interpretation and Conclusions. Patients with hematologic malignancies are currently
at higher risk of IFI caused by molds than by yeasts, and the incidence of IFI is
highest among patients with acute myeloid leukemia. Aspergillus spp are still the
most common pathogens, followed by Candida spp. Other agents are rare. The attributable
mortality rate for aspergillosis has dropped from 60-70% to approximately
40%. Candidemia-related mortality remains within the 30-40% range reported in literature
although the incidence has decreased.
AB - Background and Objectives. The aim of this study was to evaluate the incidence and
outcome of invasive fungal infections (IFI) in patients with hematologic malignancies.
Design and Methods. This was a retrospective cohort study of patients admitted
between 1999 and 2003 to 18 hematology wards in Italy. Each participating center
provided information on all patients with newly diagnosed hematologic malignancies
admitted during the survery period and on all episodes of IFI experienced by these
patients.
Results. The cohort was formed of 11,802 patients with hematologic malignacies:
acute leukemia (myeloid 3012, lymphoid 1173), chronic leukemia (myeloid 596, lymphoid
1104), lymphoma (Hodgkin’s 844, non-Hodgkin’s 3457), or multiple myeloma
(1616). There were 538 proven or probable IFI (4.6%); 373 (69%) occurred in
patients with acute myeloid leukemia. Over half (346/538) were caused by molds
(2.9%), in most cases Aspergillus spp. (310/346). The 192 yeast infections (1.6%)
included 175 cases of candidemia. Overall and IFI-attributable mortality rates were
2% (209/11802) and 39% (209/538), respectively. The highest IFI-attributable mortality
rates were associated with zygomycosis (64%) followed by fusariosis (53%),
aspergillosis (42%), and candidemia (33%).
Interpretation and Conclusions. Patients with hematologic malignancies are currently
at higher risk of IFI caused by molds than by yeasts, and the incidence of IFI is
highest among patients with acute myeloid leukemia. Aspergillus spp are still the
most common pathogens, followed by Candida spp. Other agents are rare. The attributable
mortality rate for aspergillosis has dropped from 60-70% to approximately
40%. Candidemia-related mortality remains within the 30-40% range reported in literature
although the incidence has decreased.
KW - fungal infection
KW - leukemia
KW - fungal infection
KW - leukemia
UR - http://hdl.handle.net/10807/3856
M3 - Article
SN - 0390-6078
SP - 1068
EP - 1075
JO - Haematologica
JF - Haematologica
ER -