Epidemiology and analysis of invasive fungal infections in patients withhematological malignancies: a single-center real-life experience

Abstract

Background/aim: Invasive fungal infection (IFI) causes morbidity and mortality among patients with hematological malignancies. We evaluated the incidence and treatment characteristics of IFIs between October 2012 and December 2013. Materials and methods:Patients who received chemotherapy or stem cell transplantation were retrospectively evaluated. Fungal infections were classified according to EORTC criteria.Results: Prophylaxis and antifungal therapy were given in 30.5% and 23.6% of 522 chemotherapy courses, respectively. The incidence of proven/probable IFI was 6.7%. The incidence of IFI among patients who received prophylaxis was significantly higher than among those who did not receive it (11.3% vs. 4.6%, P = 0.005). There was no significant difference between patients who received mold-active and no mold-active prophylaxis (P = 0.098). The most common single agent therapy and causative pathogen was liposomal amphotericin B (57.1%) and Aspergillus (n = 5), respectively. IFI-attributable mortality rate was 14.2% in 6 weeks. Conclusion:The IFI incidence and mortality rate were similar to that reported in the literature. The IFI rate was higher in the group using prophylaxis, as this is a high-risk group. Although the IFI rate was not significantly different between groups using prophylaxis, patients should be followed closely for the effective use of posaconazole prophylaxis.

Epidemiology and treatment approaches in management of invasive fungal infections in hematological malignancies: Results from a single-centre study

“…Our results indicated that the rate of systemic AFT, the incidence of probable/proven IFI and IFI-attributable mortality were 13%, 5% and 20%, respectively, which were comparable with the findings reported from other studies in this particular setting [1–4,24,25]. The SEIFEM-2004 study reported an incidence of IFI of 4.6%, and IFI-attributable mortality rate was 39%, higher than ours [1].…”

“…The SEIFEM-2004 study reported an incidence of IFI of 4.6%, and IFI-attributable mortality rate was 39%, higher than ours [1]. In two recent studies from Turkish and Taiwan groups incidence of probable/proven IFI was 6.7% and 5.6% and IFI-attributable mortality was 14.2% and 5.9% respectively [24,25]. In the Hema-e-Chart registry 14% of patients died within 12 weeks after the start of antifungal therapy; IFI-attributable mortality was 30.4% and 17.3% in yeast and proven/probable mold infections, respectively [4].…”

Estimated burden of serious human fungal diseases in Turkey

“…There are currently no epidemiological data on nation‐wide burden of fungal infections in Turkey, a country located at the crossroads between Eastern Europe and Western Asia with prominent geographical and socioeconomic diversity. Several studies have examined the epidemiology of fungal infections and antifungal utilisation in Turkey, but most were local, single‐centre or regional and focused on individual infections in specific populations. For instance, the epidemiology of candidiasis was evaluated retrospectively at the Hacettepe University Hospital in Ankara between January 2001 and December 2010.…”

“…A single‐centre study between October 2012 and December 2013 at Ege University in İzmir showed that incidence of proven and probable invasive fungal infections (IFIs) was 6.7% in those with haematological disease. Prophylaxis and antifungal therapy were given only in 30.5% and 23.6% of 522 chemotherapy episodes, respectively . Another study reported the epidemiological trends in antifungal treatment on the national level; 408 patients and 505 episodes of invasive fungal infections was recorded.…”

A Prospective Observational Multi-institutional Study on Invasive Fungal Infections Following Chemotherapy for Acute Myeloid Leukemia (MISFIC Study): A Real World Scenario from India

“…The overall incidence of IFI was high at 26.5% with an incidence of Proven/probable IFI being 8.25%. A metaanalysis involving 49 published studies suggested a IA risk of 4% with the use of anti-fungal prophylaxis but real world data report incidences ranging from 1.7 to 12% despite the use of antifungal prophylaxis [19][20][21]. The actual incidence in our study may have been even higher since few centres did not have access to the use of galactomannan antigen during the period of this study and therefore all IFIs from those centres were reported as possible IFI.…”