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Incidence of Invasive Fungal Infections in Patients With Previously Untreated Acute Myeloid Leukemia Receiving Venetoclax and Azacitidine
Resource type
Journal Article
Authors/contributors
- Zhang, Alexander (Author)
- Johnson, Tanner (Author)
- Abbott, Diana (Author)
- Phupitakphol, Tanit (Author)
- Gutman, Jonathan A (Author)
- Pollyea, Daniel A (Author)
- Koullias, Yiannis (Author)
Title
Incidence of Invasive Fungal Infections in Patients With Previously Untreated Acute Myeloid Leukemia Receiving Venetoclax and Azacitidine
Abstract
Abstract
Background
Acute myeloid leukemia (AML) is associated with poor prognosis, particularly in elderly patients with comorbidities. Combining azacitidine (AZA) with BCL-2 inhibitor venetoclax (VEN) demonstrated significant improvement in outcomes for newly-diagnosed AML patients compared to AZA alone. However, this regimen is myelosuppressive, and the incidence of invasive fungal infections (IFIs) and impact of antifungal prophylaxis are not well defined.
Methods
This retrospective cohort study evaluated newly-diagnosed AML patients treated with VEN/AZA at the University of Colorado Hospital from January 2014 to August 2020. Patients with history of prior IFI were excluded. Primary outcome was IFI incidence during VEN/AZA therapy. χ2 and Fisher exact tests assessed the impact of patient demographics, AML-specific risk factors, and receipt of antifungal prophylaxis on IFI incidence.
Results
144 VEN/AZA-treated AML patients were included in the study. 25 (17%) patients developed IFI: 8% (n = 2) “proven,” 24% (n = 6) “probable,” and 68% (n = 17) “possible” per European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium criteria. There was no statistically significant association between IFI incidence with age, sex, or European LeukemiaNet classification. 10 patients received antifungal prophylaxis; none developed IFI. IFI incidence rate per 1000 patient-days was greatest 0–9 days after starting VEN/AZA, at 8.39.
Conclusions
Incidence of “proven” and “probable” IFI in our VEN/AZA-treated AML cohort was 5.6%, in-line with incidence rates reported by recent similar studies. Furthermore, IFI incidence decreased as days from starting VEN/AZA therapy increased.
Publication
Open Forum Infectious Diseases
Date
2022-10-05
Volume
9
Issue
10
Pages
ofac486
Accessed
11/4/22, 9:18 AM
ISSN
2328-8957
Language
en
Library Catalog
DOI.org (Crossref)
Citation
Zhang, A., Johnson, T., Abbott, D., Phupitakphol, T., Gutman, J. A., Pollyea, D. A., & Koullias, Y. (2022). Incidence of Invasive Fungal Infections in Patients With Previously Untreated Acute Myeloid Leukemia Receiving Venetoclax and Azacitidine. Open Forum Infectious Diseases, 9(10), ofac486. https://doi.org/10.1093/ofid/ofac486
ORGANISMS
DRUGS AND THERAPIES
HEME-ONC AND CELLULAR THERAPIES
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