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Epidemiology and treatment outcome of invasive fungal infections in patients with hematological malignancies

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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.

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Acknowledgments

The authors thank the members of the Hokkaido Hematology Study Group.

Conflict of interest

The authors declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Hematology, National Hospital Organization Hokkaido Cancer Center, 4-2-3-54 Kikusui, Shiroishi-ku, Sapporo, 003-0804, Japan

    Mitsutoshi Kurosawa & Masakatsu Yonezumi

  2. Stem Cell Transplantation Center, Hokkaido University Hospital, Sapporo, Japan

    Satoshi Hashino, Junji Tanaka & Mitsufumi Nishio

  3. Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Makoto Kaneda

  4. Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan

    Shuichi Ota

  5. Department of Hematology and Oncology, Asahikawa Red Cross Hospital, Asahikawa, Japan

    Kyuhei Koda

  6. Department of Pediatrics, Sapporo Medical College, Sapporo, Japan

    Nobuhiro Suzuki

  7. Department of Pediatrics, Asahikawa Medical College, Asahikawa, Japan

    Makoto Yoshida

  8. Department of Internal Medicine, Higashi Sapporo Hospital, Sapporo, Japan

    Yasuo Hirayama

  9. Fourth Department of Internal Medicine, Sapporo Medical College, Sapporo, Japan

    Rishu Takimoto

  10. Third Department of Internal Medicine, Asahikawa Medical College, Asahikawa, Japan

    Yoshihiro Torimoto

  11. Department of Internal Medicine, Aiiku Hospital, Sapporo, Japan

    Akio Mori

  12. Department of Hematology, Tenshi Hospital, Sapporo, Japan

    Tohru Takahashi

  13. Department of Pediatrics, Tenshi Hospital, Sapporo, Japan

    Susumu Iizuka

  14. First Department of Internal Medicine, Sapporo Medical College, Sapporo, Japan

    Tadao Ishida

  15. Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan

    Ryoji Kobayashi

  16. Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan

    Takanori Oda

  17. Department of Hematology, Teine Keijinkai Hospital, Sapporo, Japan

    Hajime Sakai

  18. Department of Hematology, Sapporo City General Hospital, Sapporo, Japan

    Satoshi Yamamoto

  19. Department of Gastroenterology and Hematology, Kushiro City General Hospital, Kushiro, Japan

    Fumihiko Takahashi

  20. Department of Hematology, Asahikawa City Hospital, Asahikawa, Japan

    Takashi Fukuhara

Authors
  1. Mitsutoshi Kurosawa
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  2. Masakatsu Yonezumi
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  3. Satoshi Hashino
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  4. Junji Tanaka
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  5. Mitsufumi Nishio
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  6. Makoto Kaneda
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  7. Shuichi Ota
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  8. Kyuhei Koda
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  9. Nobuhiro Suzuki
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  10. Makoto Yoshida
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  11. Yasuo Hirayama
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  12. Rishu Takimoto
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  13. Yoshihiro Torimoto
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  14. Akio Mori
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  15. Tohru Takahashi
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  16. Susumu Iizuka
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  18. Ryoji Kobayashi
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  19. Takanori Oda
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  20. Hajime Sakai
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  21. Satoshi Yamamoto
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  22. Fumihiko Takahashi
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  23. Takashi Fukuhara
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Correspondence to Mitsutoshi Kurosawa.

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Kurosawa, M., Yonezumi, M., Hashino, S. et al. Epidemiology and treatment outcome of invasive fungal infections in patients with hematological malignancies. Int J Hematol 96, 748–757 (2012). https://doi.org/10.1007/s12185-012-1210-y

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  • DOI: https://doi.org/10.1007/s12185-012-1210-y

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