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The impact of antimicrobial prophylaxis in morbidity and infections during azacitidine treatment

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Abstract

The clinical consequences of the infectious events in patients receiving azacitidine are poorly documented. Likewise, the role of primary antimicrobial prophylaxis is unknown. In this retrospective, single-center study, we compare the impact of prophylaxis on the incidence of infection and morbidity in all consecutive higher-risk myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) patients, during the first 4 azacitidine cycles. Seventy-six patients, corresponding to 283 azacitidine cycles, were studied. There were infectious events in 43% of the patients. Development of infections led to more hospital admissions, increased red blood cells and platelet requirements, and a delay in subsequent cycles. Median overall survival was comparable between patients with or without infections. In the multivariate analysis, a neutrophil count below 0.5 × 109/L (OR 12.5 [2.6–50]) and antimicrobial prophylaxis (OR 0.1 [0.02–04]) were independent factors for the development of infection. We conclude that infectious events have a significant impact in the early clinical course of azacitidine-treated patients by increasing hospital admissions and transfusion requirements. Antimicrobial prophylaxis may prevent infections, leading to a decreased need for supportive care in these patients with poor outcome.

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Acknowledgements

Instituto Universitario de Oncología del Principado de Asturias is supported by Fundación Bancaria Caja de Ahorros de Asturias.

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Authors and Affiliations

  1. Servicio de Hematología y Hemoterapia, Hospital Universitario Central de Asturias, Oviedo, Spain

    Natalia Lorenzana, Laura Francisca Avila, Sara Alonso, Enrique Colado & Teresa Bernal

  2. Departamento de Medicina, Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, Spain

    Teresa Bernal

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  1. Natalia Lorenzana
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  2. Laura Francisca Avila
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Correspondence to Teresa Bernal.

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Lorenzana, N., Avila, L.F., Alonso, S. et al. The impact of antimicrobial prophylaxis in morbidity and infections during azacitidine treatment. Ann Hematol 96, 1833–1840 (2017). https://doi.org/10.1007/s00277-017-3091-x

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  • DOI: https://doi.org/10.1007/s00277-017-3091-x

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