title: [The clinical features and risk factors for invasive fungal infection in multiple myeloma.].
abstract: OBJECTIVE
  To study the clinical features and risk factors of invasive fungal infection (IFI) in multiple myeloma (MM).
  
  
  METHODS
  Three hundred and fifty-seven cases of MM were retrospectively analyzed for IFI, clinical features, complicating diseases, treatment of fungus and side effect of anti-fungal drugs.
  
  
  RESULTS
  Forty-four cases (12.3%) of IFI were diagnosed. Three of them were diagnosed definitely, 8 clinically and 33 probably. Ten cases incurred IFI in the induction therapy, 4 in platform, 27 in progress and 3 in the treatment with autologous stem cell transplantation. The lung was the commonest site of infection (50.0%). The total effective rates of amphotericin B liposome, voriconazole, itraconazole, caspofungin and fluconazol were 83.3%, 75.0%, 78.9%, 75.0% and 57.1% respectively (P = 0.493). In a multivariate analysis, independent factors significantly associated with IFI were diabetes (P = 0.035, OR 2.527, 95%CI 1.005 - 6.052), dialysis (P = 0.022, OR 2.768, 95%CI 1.161 - 6.600), persistent agranulocytosis (P = 0.019, OR 3.215, 95%CI 1.200 - 7.407), broad-spectrum antibiotic therapy (P = 0.009, OR 3.350, 95%CI 1.353 - 8.295) and fludarabine treatment (P = 0.001, OR 4.669, 95%CI 1.813 - 12.023).
  
  
  CONCLUSIONS
  Patients with MM are in high risk of IFI. The lung is the commonest site of infection. The therapeutic effect was similar with itraconazole, voriconazole, caspofungin and amphotericin B liposome in MM patients with complicating IFI. The risk factors for IFI in MM were diabetes, dialysis, persistent agranulocytosis and the use of broad-spectrum antibiotics and fludarabine.
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Bei-Hui
authors.initials: BH
authors.lastname: Huang
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.forename: Jun-Ru
authors.initials: JR
authors.lastname: Liu
authors.forename: Jing-Li
authors.initials: JL
authors.lastname: Gu
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D009101:Multiple Myeloma / Q000188:drug therapy; D009181:Mycoses / Q000188:drug therapy; D012307:Risk Factors
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole