Invasive pulmonary aspergillosis in acute leukemia: a still frequent condition with a negative impact on the overall treatment outcome. Issue 12 (15th October 2019)

• Record Type: Journal Article
• Authors: Cattaneo, Chiara; Gramegna, Doriana; Malagola, Michele; Pagani, Chiara; Borlenghi, Erika; Cerqui, Elisa; Passi, Angela; Sciumé, Margherita; Bernardi, Simona; Crippa, Claudia; Dalceggio, Daniela; Carbone, Cecilia; Pelizzari, Anna Maria; Re, Alessandro; Russo, Domenico; Rossi, Giuseppe
• Is Part Of: Leukemia & lymphoma. Volume 60:Issue 12(2019)
• Page Start: 3044
• Page End: 3050
• Publication Date: 2019-10-15
• Subjects: Acute Leukemia -- invasive pulmonary aspergillosis -- outcome -- allogeneic stem cell transplantation; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2019.1613535
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: We evaluated the impact of invasive pulmonary aspergillosis (IPA) on epidemiology and outcome in acute leukemia (AL), analyzing all acute myeloid (AML) and acute lymphoblastic leukemia (ALL) consecutively admitted to our Institution during a 5-year period of observation. Only AML patients received anti-mold prophylaxis. Among 175 AL patients (136 AML/39 ALL), possible and proven/probable IPA were diagnosed in 28 (16%). Frequency of IPA was similar in AML (16.2%) and in ALL (15.4%). Two-year overall survival (OS) was significantly affected by IPA (no IPA: 69.8% vs IPA: 31.7% p = .002). OS was similar in patients with proven/probable (28.2%) and possible IPA (36.4%) ( p = .003 and .065, respectively). When censoring patients at transplant, IPA still affected 2-year survival (49.6% vs 79.2%, p = .02), but only proven/probable IPA was associated with lower survival (34.7%, p = .0003). IPA negatively impacts on long-term survival of leukemia patients; antifungal prophylaxis should be adopted also during induction in ALL and in AML beyond induction therapy.