Abstract
Background: Invasive mold infections (IMI) are leading infectious causes of mortality among patients with hematological malignancies. Objectives: To determine the relative contribution of host, disease, and treatment-related factors to patient survival. Methods: An observational, retrospective cohort study reviewing the medical records of patients with hematological malignancy and IMI (2006–2016). Causes of death were classified up to 90 days after diagnosis. Kaplan–Meier and Cox regression analyses were used to determine risk factors for early, late, and overall mortality. Results: Eighty-six patients with IMI were included; 29 (34%) and 41 (47%) died within 6 and 12 weeks of diagnosis, respectively. Death was attributed to IMI in 22 (53.6%) patients, all of whom died within 45 days of diagnosis. Risk factors for early mortality were elevated serum galactomannan, treatment with amphotericin B, IMI progression 3 weeks after diagnosis, and lymphoma undergoing HCT. Late mortality was associated with relapsed/refractory malignancy and elevated serum galactomannan. Conclusions: In this single-center study of patients with IMI, infections were the most frequent causes of death, and time-dependent risk factors for death were identified. These results may help direct risk-assessment and monitoring of patients undergoing treatment of IMI.
Highlights
Invasive mold infections (IMI) are leading causes of morbidity and mortality in patients with hematological malignancies undergoing intensive chemotherapy or hematopoietic cell transplantation (HCT) [1,2]
Death in the early post-IMI period (0.5 (HR 2.37, 95% CI 1.09–5.13), treatment with amphotericin B (HR 2.71, 95% CI 1.23–5.94), and disease progression at three weeks (HR 54.04, 95% CI 7.33–398.35)
The Cox regression model for late mortality included refractory malignancy and serum galactomannan index >1.5 (Table 2). In this observational cohort study, 47% of patients with hematological malignancy and IMI died within 12 weeks, and all cases of IMI-attributable deaths occurred within 45 days of diagnosis
Summary
Invasive mold infections (IMI) are leading causes of morbidity and mortality in patients with hematological malignancies undergoing intensive chemotherapy or hematopoietic cell transplantation (HCT) [1,2]. Invasive mold infections (IMI) are leading infectious causes of mortality among patients with hematological malignancies. Risk factors for early mortality were elevated serum galactomannan, treatment with amphotericin B, IMI progression 3 weeks after diagnosis, and lymphoma undergoing HCT. Conclusions: In this single-center study of patients with IMI, infections were the most frequent causes of death, and time-dependent risk factors for death were identified. These results may help direct risk-assessment and monitoring of patients undergoing treatment of IMI
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
