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Primary fungal prophylaxis in acute leukemia patients with different risk factors: retrospective analysis from the CAESAR study

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An Erratum to this article was published on 02 June 2017

Abstract

Invasive fungal disease (IFD) is a major cause of morbidity and mortality in acute leukemia (AL) patients. The impact of primary antifungal prophylaxis (PAP) on AL patients with different risk factors is unclear. We analyzed 2015 Chinese AL patients who received a total of 2274 chemotherapy courses, including 1410 courses in acute myeloid leukemia (AML) patients and 864 courses in acute lymphocytic leukemia (ALL) patients. The IFD incidence was significantly higher among AML than ALL patients (11.8 vs. 7.1%, P < 0.001) and in patients receiving induction chemotherapy than in those receiving consolidation chemotherapy (21.6 vs. 3.7%, P < 0.001). Induction chemotherapy, decreased serum albumin, indwelling central venous catheters, parenteral nutrition, and male gender were independent risk factors for IFD in AL patients, whereas PAP independently protected against IFD development. For patients on induction chemotherapy, PAP significantly reduced IFD incidence (P < 0.001). For patients on consolidation chemotherapy, however, PAP did not significantly alter IFD incidence, although PAP did lower IFD incidence in patients with certain risk factors. PAP is highly recommended for patients on induction therapy; for those on consolidation chemotherapy, PAP should be considered for patients who present with severe neutropenia, decreased albumin, and/or an indwelling central venous catheter.

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Acknowledgements

This work was supported by Merck Sharp & Dohme China.

Author information

Authors and Affiliations

  1. Hematopoietic Stem Cell Transplantation Center, Institute of Hematology and Hospital of Blood Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 288 Nanjing Road, Heping District, 300020, Tianjin, China

    Rongli Zhang & Mingzhe Han

  2. Department of Hematology/Oncology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, 200129, Shanghai, China

    Jing Chen

  3. Hematopoietic Stem Cell Transplantation Center, the First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China

    He Huang

  4. Harbin Institute of Hematology and Oncology, Harbin, China

    Jun Ma

  5. Nanfang Hospital, Nanfang Medical University, Guangzhou, China

    Fanyi Meng

  6. Division of Hematology-Oncology, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou, China

    Yongmin Tang

  7. Department of Hematology, Fujian Medical University Union Hospital, Fuzhou, China

    Jianda Hu

  8. Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China

    Xi Zhang

  9. Peking University People’s Hospital, Peking University Institute of Hematology, No 11, Xizhimennan Street, Xicheng District, 100044, Beijing, China

    Yu Ji & Xiaojun Huang

  10. Department of Hematology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China

    Huisheng Ai

  11. Department of Hematology, TangDu Hospital, Fourth Military Medical University, Xi’an, China

    Yingmin Liang

  12. Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China

    Depei Wu

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  1. Rongli Zhang
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  2. Jing Chen
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  3. He Huang
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  7. Jianda Hu
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  8. Xi Zhang
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  9. Yu Ji
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Corresponding authors

Correspondence to Xiaojun Huang or Mingzhe Han.

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The authors declare no competing financial interests.

Additional information

The original version of this article was revised: Table 1 was published incorrectly with rows out of order and it was corrected.

An erratum to this article is available at http://dx.doi.org/10.1007/s12185-017-2269-2.

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Zhang, R., Chen, J., Huang, H. et al. Primary fungal prophylaxis in acute leukemia patients with different risk factors: retrospective analysis from the CAESAR study. Int J Hematol 106, 221–228 (2017). https://doi.org/10.1007/s12185-017-2224-2

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  • DOI: https://doi.org/10.1007/s12185-017-2224-2

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