title: Glucose-6-phosphate dehydrogenase deficiency and risk of invasive fungal disease in patients with acute myeloid leukemia.
abstract: Invasive fungal diseases (IFD) are still a leading cause of morbidity and mortality in patients with acute myeloid leukemia (AML). Glucose-6-phosphate dehydrogenase is an enzyme that leads to the production of NADPH, required to destroy microorganisms in the respiratory burst reaction of white blood cells. We evaluated the role of G6PD deficiency in susceptibility of IFD in 108 AML patients undergoing intensive chemotherapy. In all, 28 patients harbored G6PD deficiency (G6PD-), whereas 80 were normal (G6PD +). Incidence of IFD was significantly higher in G6PD- patients compared to G6PD + patients (35.7% vs. 5%, p = .0002, OR = 10, 95% CI = 2.96-37.5). Higher risk of mold infections (17.9% vs. 5%, p = .048, OR = 4.1, 95% CI = 1.0-16.6) and Candida sepsis (17.9% vs. 0%, p = .0009, OR = 37.68, 95% CI =2.0-707.1) was observed in G6PD - patients. The evaluation of G6PD activity may help to identify AML patients at higher risk of IFD, allowing to design more intensive surveillance and therapeutic strategies.
authors.affiliation: a Hematology Unit, Department of Medical Sciences and Public Health , Bone Marrow Transplant Center, R. Binaghi Hospital, University of Cagliari , Cagliari , Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Sanna
authors.affiliation: a Hematology Unit, Department of Medical Sciences and Public Health , Bone Marrow Transplant Center, R. Binaghi Hospital, University of Cagliari , Cagliari , Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Caocci
authors.affiliation: a Hematology Unit, Department of Medical Sciences and Public Health , Bone Marrow Transplant Center, R. Binaghi Hospital, University of Cagliari , Cagliari , Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ledda
authors.affiliation: a Hematology Unit, Department of Medical Sciences and Public Health , Bone Marrow Transplant Center, R. Binaghi Hospital, University of Cagliari , Cagliari , Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Orrù
authors.affiliation: b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Fozza
authors.affiliation: a Hematology Unit, Department of Medical Sciences and Public Health , Bone Marrow Transplant Center, R. Binaghi Hospital, University of Cagliari , Cagliari , Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Deias
authors.affiliation: b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Tidore
authors.affiliation: b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Dore
authors.affiliation: a Hematology Unit, Department of Medical Sciences and Public Health , Bone Marrow Transplant Center, R. Binaghi Hospital, University of Cagliari , Cagliari , Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: La Nasa
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D005954:Glucosephosphate Dehydrogenase / Q000378:metabolism; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications / Q000201:enzymology*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D053208:Kaplan-Meier Estimate; D007951:Leukemia, Myeloid / Q000150:complications / Q000188:drug therapy* / Q000628:therapy; D007962:Leukocytes / Q000187:drug effects / Q000378:metabolism / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D005954:Glucosephosphate Dehydrogenase
keywords: Candida; G6PD; acute myeloid leukemia; aspergillosis; fungal infection