title: Invasive aspergillosis: an important risk factor on the short- and long-term survival of acute myeloid leukemia (AML) patients.
abstract: Invasive aspergillosis (IA) during induction chemotherapy of acute myeloid leukemia (AML) could worsen the prognosis. Our objective was to study how the development of IA during AML interferes with the therapeutic strategy and to evaluate its impact on the short- and long-term survival. Newly diagnosed AML patients between the years 2004 and 2007 were retrospectively analyzed. The outcome was death of the patient. A Cox proportional hazards model with the diagnosis of IA and post-induction response evaluation as the main exposure was fitted. Overall, 262 patients were analyzed and 58 IA were observed. The 2-year survival of patients having had remission of AML was 54% and, for patients with failure of chemotherapy, it was 5% (p < 0.001). The 2-year survival of patients having had IA was 14%, and without IA, it was 32% (p = 0.01). Multivariate analysis showed that IA was associated with a higher risk of death in case of remission compared to no IA (hazard ratio [HR] = 1.66 [1.05-2.65], p = 0.031) and also in case of failure (HR = 6.43, p < 0.001). IA was associated with an increased risk of death for patients if they were either in remission or in failure after induction chemotherapy.
authors: Hematology Department, Edouard Herriot Hospital, Hospices Civils de Lyon, 5 Place d'Arsonval, 69437, Lyon Cedex 03, France. mauricette.michallet@chu-lyon.fr
authors: M
authors: M
authors: Michallet
authors: T
authors: T
authors: Bénet
authors: M
authors: M
authors: Sobh
authors: S
authors: S
authors: Kraghel
authors: M
authors: M
authors: El Hamri
authors: G
authors: G
authors: Cannas
authors: F E
authors: FE
authors: Nicolini
authors: H
authors: H
authors: Labussière
authors: S
authors: S
authors: Ducastelle
authors: F
authors: F
authors: Barraco
authors: X
authors: X
authors: Thomas
authors: Y
authors: Y
authors: Chelghoum
authors: M-C
authors: MC
authors: Nicolle
authors: A-L
authors: AL
authors: Bienvenu
authors: F
authors: F
authors: Persat
authors: F
authors: F
authors: De Monbrison
authors: S
authors: S
authors: Picot
authors: P
authors: P
authors: Vanhems
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001228:Aspergillosis / Q000453:epidemiology* / Q000401:mortality*; D005260:Female; D016469:Fungemia / Q000453:epidemiology* / Q000401:mortality*; D006801:Humans; D016867:Immunocompromised Host; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents