title: Epidemiology and treatment outcome of invasive fungal infections in patients with hematological malignancies.
abstract: Invasive fungal infection (IFI) causes morbidity and mortality among patients with hematological malignancies who receive cytotoxic chemotherapy or hematopoietic stem cell transplantation (HSCT). We evaluated the incidence and treatment outcomes of proven and probable IFI in 22 institutions between 2006 and 2008 following the recent European Organization for Research and Treatment of Cancer/Mycosis Study Group (EORTC/MSG) consensus criteria. We analyzed 2,821 patients with hematological malignancies, including 597 who had undergone HSCT; these included patients with acute leukemia (n = 697), myelodysplastic syndrome (n = 284), lymphoma (n = 1465), or multiple myeloma (n = 375). IFIs were diagnosed in 38 (1.3%) patients (18 proven and 20 probable), including 20 patients who underwent HSCT and 18 who received chemotherapy alone; these included patients with aspergillosis (n = 23), candidiasis (n = 6), mucormycosis (n = 6), trichosporonosis (n = 2), and geotrichosis (n = 1). The incidence of IFI was 5.4 % in allogeneic HSCT patients, 0.4 % in autologous HSCT patients, and 0.8 % in patients receiving chemotherapy alone. Eighteen patients with aspergillosis were diagnosed with probable pulmonary IFI as determined by computed tomography scan and positive galactomannan assay. Overall, antifungal targeted therapies resulted in successful outcomes in 60.0 % of patients. IFI-attributable mortality rate was higher in HSCT patients than in those receiving chemotherapy alone, but the difference was not statistically significant.
authors.affiliation: Department of Hematology, National Hospital Organization Hokkaido Cancer Center, 4-2-3-54 Kikusui, Sapporo, 003-0804, Japan. kurosawa@sap-cc.go.jp
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Kurosawa
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Yonezumi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hashino
authors.forename: Junji
authors.initials: J
authors.lastname: Tanaka
authors.forename: Mitsufumi
authors.initials: M
authors.lastname: Nishio
authors.forename: Makoto
authors.initials: M
authors.lastname: Kaneda
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ota
authors.forename: Kyuhei
authors.initials: K
authors.lastname: Koda
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Suzuki
authors.forename: Makoto
authors.initials: M
authors.lastname: Yoshida
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hirayama
authors.forename: Rishu
authors.initials: R
authors.lastname: Takimoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Torimoto
authors.forename: Akio
authors.initials: A
authors.lastname: Mori
authors.forename: Tohru
authors.initials: T
authors.lastname: Takahashi
authors.forename: Susumu
authors.initials: S
authors.lastname: Iizuka
authors.forename: Tadao
authors.initials: T
authors.lastname: Ishida
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kobayashi
authors.forename: Takanori
authors.initials: T
authors.lastname: Oda
authors.forename: Hajime
authors.initials: H
authors.lastname: Sakai
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Takahashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukuhara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D055744:Invasive Pulmonary Aspergillosis / Q000188:drug therapy / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications; D009894:Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000935:Antifungal Agents