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Analysis of bacteremia/fungemia and pneumonia accompanying acute myelogenous leukemia from 1987 to 2001 in the Japan Adult Leukemia Study Group

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Abstract

We analyzed the incidence and prognosis of bacteremia/fungemia and pneumonia during remission induction therapy of a newly diagnosed acute myelogenous leukemia (AML) in the Japan Adult Leukemia Study Group treated with individual protocols of AML-87/-89 (1987–1991), AML-92 (1992–1995), AML-95 (1995–1997), and AML-97 (1997–2001). Bacteremia/fungemia was present in 251 of 2585 cases (9.7%); the causative microorganism was gram-positive bacteria (GPB) in 122 cases (49%), gram-negative bacteria (GNB) in 90 cases (36%), fungi (F) in 31 cases (12%), and polymicrobes (P) in 8 cases (3%). Particularly prevalent were Pseudomonas aeruginosa in 49 cases (20%), Staphylococcus epidermidis in 29 cases (12%), and Staphylococcus aureus in 25 cases (10%). With AML-87/-89, incidence of bacteremia/fungemia was 11.8% while it was 9.4% with AML-92, 8.7% with AML-95, and 9.2% with AML-97. The proportion of GPB, GNB, F, and P was 40, 41, 16, and 3% in AML-87/-89, 46, 40, 11, and 3% in AML-92, 48, 39, 11, and 2% in AML-95, and 59, 26, 11, and 4% in AML-97. The mortality rate by period was 26.5, 16.4, 14.0, and 6.8%, respectively. Pneumonia was found in 433 cases (16.8%); microbiological research covered 359 cases of AML-87/-89, AML-92, AML-97 and excluded AML-95 as there was no listing for the causative microorganism on questionnaires. Microbiologically documented pneumonia was found in 123 cases (34.3%), with GPB in 33 cases (27%), GNB in 28 cases (23%), F in 44 cases (36%), and P in 18 cases (15%); particularly prevalent were Aspergillus in 23 cases (19%), Staphylococcus aureus in 16 cases (13%), and Pseudomonas aeruginosa in 15 cases (12%). The incidence of pneumonia overall was 24.6% with AML-87/-89, 16.9% with AML-92, 13.9% with AML-95, and 12.9% with AML-97, with a mortality rate of 28.9, 33.3, 16.7, and 16.7%, respectively. Incidence of bacteremia/fungemia and pneumonia complicating AML has tended to decline in recent years, and mortality has also tended to improve.

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Acknowledgments

We thank all participating physicians from the institutions in the JALSG for their cooperation.

Author information

Authors and Affiliations

  1. Fourth Department of Internal Medicine, Teikyo University School of Medicine, Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki, 213-8507, Japan

    Minoru Yoshida

  2. Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan

    Nobu Akiyama

  3. Department of Rheumatology/Hematology/Infectious Disease, Yokohama City University Hospital, Yokohama, Japan

    Hiroyuki Fujita

  4. Department of Hematology and Rheumatology, Division of Medicine, Nihon University School of Medicine, Tokyo, Japan

    Katsuhiro Miura

  5. Division of Hematology, Department of Internal Medicine, Kinki University School of Medicine, Osaka, Japan

    Jun-ichi Miyatake

  6. Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine, Maebashi, Japan

    Hiroshi Handa

  7. Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan

    Katsuyuki Kito

  8. Division of Hematology and Oncology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan

    Masatomo Takahashi

  9. Department of Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan

    Kazuyuki Shigeno

  10. Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan

    Yoshinobu Kanda

  11. Leukemia Research Center, Saiseikai Maebashi Hospital, Maebashi, Japan

    Naoko Hatsumi

  12. Department of Hematology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan

    Shigeki Ohtake

  13. Division of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    Hisashi Sakamaki

  14. Oncology Center, Hamamatsu University School of Medicine, Hamamatsu, Japan

    Kazunori Ohnishi

  15. Division of Hematology, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan

    Shuichi Miyawaki

  16. Aichi Shukutoku University, Nagoya, Japan

    Ryuzo Ohno

  17. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Tomoki Naoe

Authors
  1. Minoru Yoshida
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  2. Nobu Akiyama
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  3. Hiroyuki Fujita
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  4. Katsuhiro Miura
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  5. Jun-ichi Miyatake
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  7. Katsuyuki Kito
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  8. Masatomo Takahashi
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  9. Kazuyuki Shigeno
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  10. Yoshinobu Kanda
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  11. Naoko Hatsumi
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  12. Shigeki Ohtake
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  13. Hisashi Sakamaki
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  14. Kazunori Ohnishi
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  15. Shuichi Miyawaki
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  16. Ryuzo Ohno
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  17. Tomoki Naoe
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Corresponding author

Correspondence to Minoru Yoshida.

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For the Japan Adult Leukemia Study Group.

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Yoshida, M., Akiyama, N., Fujita, H. et al. Analysis of bacteremia/fungemia and pneumonia accompanying acute myelogenous leukemia from 1987 to 2001 in the Japan Adult Leukemia Study Group. Int J Hematol 93, 66–73 (2011). https://doi.org/10.1007/s12185-010-0746-y

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  • DOI: https://doi.org/10.1007/s12185-010-0746-y

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