title: Impact of vancomycin-resistant enterococcal bacteremia on outcome during acute myeloid leukemia induction therapy.
abstract: This study aimed to identify the rate and impact of vancomycin-resistant enterococcal (VRE) bacteremia in patients with acute myeloid leukemia (AML) receiving induction chemotherapy (IC). Thirty-seven (10.6%) of 350 patients had VRE bacteremia during IC, with increasing rates of VRE bacteremia over the course of the study period. The overall complete remission (CR) rate for the cohort was 73%, and there was no difference in CR rate between the VRE bacteremia and non-VRE bacteremia cohorts (70% vs. 73%, p = 0.70). Unadjusted median overall survival (OS) was 12.8 months, and differed significantly between those with and without VRE bacteremia (7.1 months vs. 13.1 months, respectively; p = 0.03). The presence of VRE bacteremia during IC for AML was independently associated with increased all-cause mortality (hazard ratio 1.72, 95% confidence interval 1.13-2.63, p = 0.01).
authors.affiliation: a Leukemia Program, Department of Hematologic Oncology and Blood Disorders , Cleveland Clinic Taussig Cancer Institute , Cleveland , OH , USA.
authors.forename: Moshe C
authors.initials: MC
authors.lastname: Ornstein
authors.affiliation: a Leukemia Program, Department of Hematologic Oncology and Blood Disorders , Cleveland Clinic Taussig Cancer Institute , Cleveland , OH , USA.
authors.forename: Sudipto
authors.initials: S
authors.lastname: Mukherjee
authors.affiliation: a Leukemia Program, Department of Hematologic Oncology and Blood Disorders , Cleveland Clinic Taussig Cancer Institute , Cleveland , OH , USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Keng
authors.affiliation: b Quantitative Health Sciences, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Elson
authors.affiliation: a Leukemia Program, Department of Hematologic Oncology and Blood Disorders , Cleveland Clinic Taussig Cancer Institute , Cleveland , OH , USA.
authors.forename: Ramon V
authors.initials: RV
authors.lastname: Tiu
authors.affiliation: a Leukemia Program, Department of Hematologic Oncology and Blood Disorders , Cleveland Clinic Taussig Cancer Institute , Cleveland , OH , USA.
authors.forename: Yogenthiran
authors.initials: Y
authors.lastname: Saunthararajah
authors.affiliation: a Leukemia Program, Department of Hematologic Oncology and Blood Disorders , Cleveland Clinic Taussig Cancer Institute , Cleveland , OH , USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Maggiotto
authors.affiliation: a Leukemia Program, Department of Hematologic Oncology and Blood Disorders , Cleveland Clinic Taussig Cancer Institute , Cleveland , OH , USA.
authors.forename: Madeline
authors.initials: M
authors.lastname: Schaub
authors.affiliation: a Leukemia Program, Department of Hematologic Oncology and Blood Disorders , Cleveland Clinic Taussig Cancer Institute , Cleveland , OH , USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Banks
authors.affiliation: a Leukemia Program, Department of Hematologic Oncology and Blood Disorders , Cleveland Clinic Taussig Cancer Institute , Cleveland , OH , USA.
authors.forename: Anjali
authors.initials: A
authors.lastname: Advani
authors.affiliation: a Leukemia Program, Department of Hematologic Oncology and Blood Disorders , Cleveland Clinic Taussig Cancer Institute , Cleveland , OH , USA.
authors.forename: Matt
authors.initials: M
authors.lastname: Kalaycio
authors.affiliation: a Leukemia Program, Department of Hematologic Oncology and Blood Disorders , Cleveland Clinic Taussig Cancer Institute , Cleveland , OH , USA.
authors.forename: Jaroslaw P
authors.initials: JP
authors.lastname: Maciejewski
authors.affiliation: a Leukemia Program, Department of Hematologic Oncology and Blood Disorders , Cleveland Clinic Taussig Cancer Institute , Cleveland , OH , USA.
authors.forename: Mikkael A
authors.initials: MA
authors.lastname: Sekeres
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000150:complications / Q000382:microbiology*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000382:microbiology*; D054884:Host-Pathogen Interactions; D006801:Humans; D060828:Induction Chemotherapy; D053208:Kaplan-Meier Estimate; D007951:Leukemia, Myeloid / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D011379:Prognosis; D016016:Proportional Hazards Models; D012074:Remission Induction; D065507:Vancomycin-Resistant Enterococci / Q000502:physiology*; D055815:Young Adult
keywords: AML; VRE; enterococcus; induction chemotherapy; leukemia; survival