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.

Invasive aspergillosis in patients with acute myeloid leukemia: a SEIFEM-2008 registry study / Pagano, L; Caira, M; Candoni, A; Offidani, M; Martino, B; Specchia, G; Pastore, D; Stanzani, M; Cattaneo, C; Fanci, R; Caramatti, Cecilia; Rossini, F; Luppi, M; Potenza, L; Ferrara, F; Mitra, Me; Fadda, Rm; Invernizzi, R; Aloisi, T; Picardi, M; Bonini, A; Vacca, A; Chierichini, A; Melillo, L; de Waure, C; Fianchi, L; Riva, M; Leone, G; Aversa, Franco; Nosari, A.. - In: HAEMATOLOGICA. - ISSN 0390-6078. - 95(4):(2010), pp. 644-650. [10.3324/haematol.2009.012054]

Invasive aspergillosis in patients with acute myeloid leukemia: a SEIFEM-2008 registry study.

CARAMATTI, Cecilia;AVERSA, Franco;
2010-01-01

Abstract

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.
2010
Invasive aspergillosis in patients with acute myeloid leukemia: a SEIFEM-2008 registry study / Pagano, L; Caira, M; Candoni, A; Offidani, M; Martino, B; Specchia, G; Pastore, D; Stanzani, M; Cattaneo, C; Fanci, R; Caramatti, Cecilia; Rossini, F; Luppi, M; Potenza, L; Ferrara, F; Mitra, Me; Fadda, Rm; Invernizzi, R; Aloisi, T; Picardi, M; Bonini, A; Vacca, A; Chierichini, A; Melillo, L; de Waure, C; Fianchi, L; Riva, M; Leone, G; Aversa, Franco; Nosari, A.. - In: HAEMATOLOGICA. - ISSN 0390-6078. - 95(4):(2010), pp. 644-650. [10.3324/haematol.2009.012054]
File in questo prodotto:
File Dimensione Formato  
caramatti 2.pdf

non disponibili

Tipologia: Documento in Post-print
Licenza: Creative commons
Dimensione 432.48 kB
Formato Adobe PDF
432.48 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2305488
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 280
  • ???jsp.display-item.citation.isi??? 247
social impact