title: Infectious complications in adult acute myeloid leukemia: analysis of the Acute Leukemia French Association-9802 prospective multicenter clinical trial.
abstract: Infections are a major complication in patients with acute myeloid leukemia undergoing intensive chemotherapy. They remain a major cause of therapy-associated morbidity and mortality, and represent a frequent cause of treatment withdrawal. An analysis of the medical charts of 459 younger adults included in the multicenter Acute Leukemia French Association (ALFA)-9802 trial showed that 1369 febrile episodes occurred among the 459 registered patients, including fever without identifiable source (23%) and clinically or microbiologically documented infections (77%). Bloodstream infections occurred in 314 episodes, including 129 documented episodes with Gram-positive and 96 with Gram-negative pathogens. Pulmonary infection was diagnosed in 144/1054 documented infectious episodes (14%). Invasive fungal infection was probable or proven in 116 patients. In all, 15 patients died of infection-associated complications, of whom seven died during early induction therapy, one during salvage therapy and seven during consolidation therapy. Better supportive care strategies may improve overall survival in patients undergoing chemotherapy for acute myeloid leukemia.
authors.affiliation: Department of Hematology, Hôpital Edouard Herriot, Lyon, France.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Cannas
authors.forename: Cécile
authors.initials: C
authors.lastname: Pautas
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Raffoux
authors.forename: Bruno
authors.initials: B
authors.lastname: Quesnel
authors.forename: Stéphane
authors.initials: S
authors.lastname: de Botton
authors.forename: Thierry
authors.initials: T
authors.lastname: de Revel
authors.forename: Oumedaly
authors.initials: O
authors.lastname: Reman
authors.forename: Claude
authors.initials: C
authors.lastname: Gardin
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elhamri
authors.forename: Nicolas
authors.initials: N
authors.lastname: Boissel
authors.forename: Pierre
authors.initials: P
authors.lastname: Fenaux
authors.forename: Mauricette
authors.initials: M
authors.lastname: Michallet
authors.forename: Sylvie
authors.initials: S
authors.lastname: Castaigne
authors.forename: Hervé
authors.initials: H
authors.lastname: Dombret
authors.forename: Xavier
authors.initials: X
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D060830:Consolidation Chemotherapy; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D060828:Induction Chemotherapy; D007239:Infections / Q000453:epidemiology* / Q000209:etiology*; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008495:Medical Oncology / Q000458:organization & administration; D008875:Middle Aged; D011446:Prospective Studies; D016879:Salvage Therapy; D012955:Societies, Medical / Q000458:organization & administration; D055815:Young Adult