Abstract | BACKGROUND: PATIENTS AND METHODS: We identified patients with AML ≥ 18 years old undergoing induction chemotherapy during 2 time periods: period 1, fluconazole prophylaxis from August 1, 2013 to September 30, 2015, and period 2, no prophylaxis from October 1, 2015 to December 31, 2017. The primary outcome was incidence of proven or probable IFI. Secondary outcomes included types of IFIs and 60-day overall survival (OS). IFI was defined by the 2002 European Organization for Research and Treatment of Cancer/ Mycoses Study Group Consensus criteria. RESULTS: One hundred forty-four patients received induction chemotherapy over the 2 time periods. In the prophylaxis versus no-prophylaxis groups, the rate of proven or probable IFIs was 4 (5%) of 87 versus 12 (21%) of 57 (P = .01). The total number of proven IFIs was 3 (3%) of 87 versus 4 (7%) of 57 (P = .44), whereas probable IFIs were 1 (1%) of 87 versus 8 (14%) of 57 (P < .01). No difference was observed in fungemia. Incidence of IFIs was too low to detect resistance patterns. OS at 60 days was improved in with fluconazole prophylaxis compared with no prophylaxis (hazard ratio, 0.329; 95% confidence interval, 0.12-0.89; P = .028). CONCLUSION: Observed rates of proven or probable IFI were lower in the fluconazole prophylaxis group versus the no-prophylaxis group. Sixty-day OS was higher with fluconazole prophylaxis. Further study is required to evaluate how fluconazole may impart the differences in survival seen in this analysis.
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Authors | Jessie Signorelli, Matthew Lei, Jenna Lam, Marla Jalbut, Philip C Amrein, Amir T Fathi, Gabriela Hobbs, Hanno Hock, Steven Lawrence McAfee, Alyssa R Letourneau, Rupa Narayan, Andrew Brunner |
Journal | Clinical lymphoma, myeloma & leukemia
(Clin Lymphoma Myeloma Leuk)
Vol. 20
Issue 11
Pg. e883-e889
(11 2020)
ISSN: 2152-2669 [Electronic] United States |
PMID | 32917574
(Publication Type: Journal Article)
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Copyright | Copyright © 2020 Elsevier Inc. All rights reserved. |
Chemical References |
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Antifungal Agents
(therapeutic use)
- Female
- Humans
- Incidence
- Invasive Fungal Infections
(etiology, pathology)
- Leukemia, Myeloid, Acute
(complications, pathology)
- Male
- Middle Aged
- Young Adult
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