Invasive Fungal Infections in Patients with Acute Myeloid Leukemia Undergoing Intensive Chemotherapy. 2020

Pinki Mishra, and Narendra Agrawal, and Dinesh Bhurani, and Nidhi Bharal Agarwal
1Centre for Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, 110062 India.

Patients with hematological malignancies are severely immunocompromised and are at high risk of invasive fungal infection (IFI), particularly those undergoing remission-induction chemotherapy for acute myeloid leukemia (AML). IFIs are a major cause of morbidity and mortality in such patients. We planned to study the incidence of IFI in patients with AML undergoing intensive chemotherapy and receiving antifungal prophylaxis. We retrospectively reviewed consecutive 46 patients with non-M3 AML, who received induction chemotherapy and systemic antifungal prophylaxis. None of the patients had IFI at the time of initiation of the chemotherapy. Patients were monitored for the occurrence of IFI using high-resolution computerized tomography of the chest or para-nasal sinus and test for galactomannan antigen on serum or broncho-alveolar lavage and were followed up for 90 days. Of the 46 patients on intensive chemotherapies, 41, 4 and 1 patients were started on posaconazole, amphotericin B and voriconazole prophylaxis, respectively. The occurrence of possible and probable IFI was observed in 16 and 4 patients respectively, in which 19 patients were on posaconazole and 1 patient was on amphotericin-B prophylaxis. Overall mortality in the study population was 11 (23.9%). Four out of 20 patients died with IFI but none of the death was attributable to IFI. IFI still remains a significant cause of morbidity and mortality in patients with AML despite universal use of antifungal prophylaxis. With effective pharmacotherapy, the mortality due to IFI is preventable. Appropriate antifungal prophylaxis strategy still needs to be developed through larger and prospective studies.

UI MeSH Term Description Entries

Related Publications

Pinki Mishra, and Narendra Agrawal, and Dinesh Bhurani, and Nidhi Bharal Agarwal
April 2020, Mycopathologia,
Pinki Mishra, and Narendra Agrawal, and Dinesh Bhurani, and Nidhi Bharal Agarwal
March 2014, Haematologica,
Pinki Mishra, and Narendra Agrawal, and Dinesh Bhurani, and Nidhi Bharal Agarwal
May 2006, The Kaohsiung journal of medical sciences,
Pinki Mishra, and Narendra Agrawal, and Dinesh Bhurani, and Nidhi Bharal Agarwal
January 2018, Leukemia & lymphoma,
Pinki Mishra, and Narendra Agrawal, and Dinesh Bhurani, and Nidhi Bharal Agarwal
August 2023, EJHaem,
Pinki Mishra, and Narendra Agrawal, and Dinesh Bhurani, and Nidhi Bharal Agarwal
January 2004, Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti,
Pinki Mishra, and Narendra Agrawal, and Dinesh Bhurani, and Nidhi Bharal Agarwal
July 2023, Blood advances,
Pinki Mishra, and Narendra Agrawal, and Dinesh Bhurani, and Nidhi Bharal Agarwal
February 1988, The American journal of medicine,
Pinki Mishra, and Narendra Agrawal, and Dinesh Bhurani, and Nidhi Bharal Agarwal
November 2018, Journal of oncology practice,
Pinki Mishra, and Narendra Agrawal, and Dinesh Bhurani, and Nidhi Bharal Agarwal
December 2019, Blood advances,
Copied contents to your clipboard!