title: [Clinical features of invasive pulmonary fungal infection secondary to malignant blood diseases].
abstract: OBJECTIVE
  To summarize the clinical features of invasive pulmonary fungal infection (IPFI) secondary to malignant blood diseases (MBD).
  
  
  METHODS
  We retrospectively analyzed the clinical data of 52 patients with IPFI secondary to MBD admitted to Peking Union Medical College Hospital from January 1995 to December 2008.
  
  
  RESULTS
  The incidences of IPFI secondary to acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), non-Hodgkin's lymphoma (NHL), and aplastic anemia (AA) were 4.6%, 3.2%, 2.8%, and 2.5%, respectively. In patients with IPFI secondary to AML, 88.5% (23/26) of the patients suffered from the infections during the non-remission (NR) period (including relapse), and 11.5% (3/26) in the complete-remission (CR) period. In all the patients with IPFI secondary to malignant blood diseases, 86.5% (45/52) of MBD were neutropenic or agranulocytic, and 67.3% (35/52) had been treated with broad-spectrum antibiotics for more than 96 hours before anti-fungal therapy. The total mortality after anti-fungal therapy was 13.7% (7/51). More than half of patients with fluconazole or itraconazole as the first-line therapy had to switch to other medicines because of poor infection control.
  
  
  CONCLUSIONS
  IPFI secondary to MBD is most common in AML patients. Patients with NR of AML, neutropenia or agranulocytosis, and long-term broad-spectrum antibiotics usage are susceptible to IPFI. Fluconazole and itraconazole have low efficacy, and other more potent anti-fungal medicines should be considered.
authors.affiliation: Department of Hematology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
authors.forename: Xue-Feng
authors.initials: XF
authors.lastname: Sun
authors.forename: Bing
authors.initials: B
authors.lastname: Han
authors.forename: Jun
authors.initials: J
authors.lastname: Feng
authors.forename: Dao-Bin
authors.initials: DB
authors.lastname: Zhou
authors.forename: Shu-Jie
authors.initials: SJ
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Xu
authors.forename: Jia-Lin
authors.initials: JL
authors.lastname: Chen
authors.forename: Li
authors.initials: L
authors.lastname: Jiao
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Ming-Hui
authors.initials: MH
authors.lastname: Duan
authors.forename: Tie-Nan
authors.initials: TN
authors.lastname: Zhu
authors.forename: Nong
authors.initials: N
authors.lastname: Zou
authors.forename: Bao-Lai
authors.initials: BL
authors.lastname: Hua
authors.forename: Hua-Cong
authors.initials: HC
authors.lastname: Cai
authors.forename: Yong-Qiang
authors.initials: YQ
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult