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学科主题临床医学
Invasive fungal infection in patients receiving chemotherapy for hematological malignancy: a multicenter, prospective, observational study in China
Sun, Yuqian1; Huang, He2; Chen, Jing3; Li, Jianyong4; Ma, Jun5; Li, Juan6; Liang, Yingmin7; Wang, Jianmin8; Li, Yan9; Yu, Kang10; Hu, Jianda11; Jin, Jie2; Wang, Chun12; Wu, Depei13; Xiao, Yang14; Huang, Xiaojun1
关键词Ifi Chemotherapy Hematological Cancer Mortality Antifungal
刊名TUMOR BIOLOGY
2015-02-01
DOI10.1007/s13277-014-2649-7
36期:2页:757-767
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Oncology
研究领域[WOS]Oncology
关键词[WOS]STEM-CELL TRANSPLANTATION ; POSACONAZOLE VS. FLUCONAZOLE ; CLINICAL-PRACTICE GUIDELINE ; ANTIFUNGAL THERAPY ; RISK-FACTORS ; NEUTROPENIC PATIENTS ; DISEASES ; EPIDEMIOLOGY ; PROPHYLAXIS ; SOCIETY
英文摘要

This stud y examined the epidemiology, risk factors, management, and outcome of invasive fungal infection (IFI) in patients receiving chemotherapy for hematological malignancy in China. IFI risk factors were analyzed using univariate analysis and multivariate logistic regression. In total, 4,192 patients receiving 4,889 chemotherapy courses were enrolled [mean age 40.7 years, 58.4 % male, 16.9 % children (< 18 years)]. The most common hematological diseases were acute myeloid leukemia (AML, 28.5 %), non-Hodgkin lymphoma (NHL, 26.3 %), and acute lymphoblastic leukemia (ALL, 20.2 %). Severe neutropenia (absolute neutrophil count [ANC] < 500/mm(3)) occurred after one third (1,633/4,889, 33.4 %) of chemotherapy courses. Incidence of proven/probable IFI was 2.1 % per chemotherapy course and higher in patients with myelodysplastic syndrome (MDS, 4.94 %), acute hyperleukocytic leukemia (AHL, 4.76 %), AML (3.83 %), or induction chemotherapy. Risk factors included ANC < 500/mm(3) [odds ratio (OR) 3.60], AML or MDS (OR 1.97), induction chemotherapy (OR 2.58), previous IFI (OR 3.08), and being male (OR 1.74). Antifungal agents, prescribed in one quarter (1,211/4,889, 24.8 %) of chemotherapy courses, included primary/secondary prophylaxis (n = 827, 16.9 %) and/or treatment (n = 655, 13.4 %; 86.9 % triazoles), which was empirical (84.3 %), pre-emptive (8.6 %), or targeted (7.1 %). Overall mortality following each chemotherapy course (1.5 %) increased in proven/probable (11.7 %) and possible IFI (8.2 %). In summary, IFI was more common in MDS, AHL, AML, or induction chemotherapy, and substantially increased mortality. Neutropenic patients receiving induction chemotherapy for AML or MDS and those with previous IFI were at particular risk. Antifungal prophylaxis showed an independent protective effect but was not commonly used, even in high-risk patients. By contrast, empiric antifungals were widely used.

语种英语
WOS记录号WOS:000350478200035
资助机构Merck Sharp Dohme China
引用统计
被引频次:18[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/56425
专题北京大学第二临床医学院_血液科
作者单位1.China Med Univ, Affiliated Hosp 1, Shenyang, Peoples R China
2.Fujian Med Univ, Union Hosp, Fuzhou, Peoples R China
3.First Peoples Hosp Shanghai, Shanghai, Peoples R China
4.Soochow Univ, Affiliated Hosp 1, Suzhou, Peoples R China
5.Shanghai Childrens Med Ctr, Shanghai, Peoples R China
6.Jiangsu Prov Hosp, Nanjing, Jiangsu, Peoples R China
7.Harbin Hematol Tumor Inst, Harbin, Peoples R China
8.Peking Univ, Inst Hematol, Peoples Hosp, Beijing Key Lab Hematopoiet Stem Cell Transplanta, Beijing 100871, Peoples R China
9.Zhejiang Univ, Sch Med, Affiliated Hosp 1, Hangzhou 310003, Zhejiang, Peoples R China
10.Sun Yat Sen Univ, Affiliated Hosp 1, Guangzhou 510275, Guangdong, Peoples R China
11.Fourth Mil Med Univ, Tangdu Hosp, Xian 710032, Peoples R China
12.Second Mil Med Univ, Changhai Hosp, Shanghai, Peoples R China
13.Wenzhou Med Coll, Affiliated Hosp 1, Wenzhou, Peoples R China
14.PLA, Gen Hosp, Guangzhou Mil Command, Guangzhou, Guangdong, Peoples R China
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GB/T 7714
Sun, Yuqian,Huang, He,Chen, Jing,et al. Invasive fungal infection in patients receiving chemotherapy for hematological malignancy: a multicenter, prospective, observational study in China[J]. TUMOR BIOLOGY,2015,36(2):757-767.
APA Sun, Yuqian.,Huang, He.,Chen, Jing.,Li, Jianyong.,Ma, Jun.,...&Huang, Xiaojun.(2015).Invasive fungal infection in patients receiving chemotherapy for hematological malignancy: a multicenter, prospective, observational study in China.TUMOR BIOLOGY,36(2),757-767.
MLA Sun, Yuqian,et al."Invasive fungal infection in patients receiving chemotherapy for hematological malignancy: a multicenter, prospective, observational study in China".TUMOR BIOLOGY 36.2(2015):757-767.
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