INVASIVE PULMONARY ASPERGILLOSIS IN ACUTE LEUKEMIA:ABOUT 57 CASES
(Abstract release date: 05/21/15)
EHA Library. Kassar O. 06/12/15; 102839; PB1801
Disclosure(s): university sfaxhematology
Olfa Kassar
Contributions
Contributions
Abstract
Abstract: PB1801
Type: Publication Only
Background
Invasive pulmonary aspergillosis (IPA) is a serious fungal infection and it’s associated with high mortality.
Aims
In this study, we evaluate the incidence and treatment outcome of IPA in acute leukemia (AL).
Methods
Our retrospective study included patients with novo acute leukemia (ALL or AML) under which occurring IPA during chemotherapy following in department of Hematology CHU Hédi CHaker Sfax between January 2009 and December 2013. The treatment of acute leukemia is based in chemotherapy and /or corticosteroids, and it is done in conventional rooms.Invasive pulmonary aspergillosis was diagnosed based on the revised definitions of invasive fungal disease from the EORTC/MSG clinical, microbiological and radiological criteria. Accordingly, the patients were diagnosed as having “proven,” “probable,” or “possible” IPA.For this, a Clinical data including clinical manifestations, diagnostic results, and treatment was collected for every patient.
Results
We analyzed 247 patients with acute leukemia. IPA was diagnosed in 57 patients .the incidence of IPA was 23% during 5 years. The average age was 29 years old (3 - 53 years old). All our patients had at least 3 criteria according to EORTC/MSG (neutropenia <500 / mm3 and prolonged, fever despite broad-spectrum antibiotics and immunosuppressive agents in the previous 30 days). The aspergillus antigenemia was positive in 26 patients (45%).The broncho-alveolar lavage (LBA) was done in 22 cases including (38%). For this, patients with aspergillosis were diagnosed with probable IPA in 45%, possible IPA in 46.5% and proven one in 5 cases (8.5%). All patients were treated with amphotericin B and relay by voriconazole. The Evolution was favorable in 28 cases (49%) with early deaths in 10 patients (18%). Twenty patients (35%) are alive with an average decline about 1 year.
Summary
The prevalence of the IPA in our series is higher than the literature (15%) because patients are treated in conventional rooms. The prevalence of proven IPA in our study is very low because of the difficulty of histological documentation (technic problem and deep thrombocytopenia) .Wherever; the precocity of diagnosis by TDM imagery and the treatment with voriconazole have improved the mortality rate in our series.
Keyword(s): Acute leukemia, Aspergillus, Voriconazole
Session topic: Publication Only
Type: Publication Only
Background
Invasive pulmonary aspergillosis (IPA) is a serious fungal infection and it’s associated with high mortality.
Aims
In this study, we evaluate the incidence and treatment outcome of IPA in acute leukemia (AL).
Methods
Our retrospective study included patients with novo acute leukemia (ALL or AML) under which occurring IPA during chemotherapy following in department of Hematology CHU Hédi CHaker Sfax between January 2009 and December 2013. The treatment of acute leukemia is based in chemotherapy and /or corticosteroids, and it is done in conventional rooms.Invasive pulmonary aspergillosis was diagnosed based on the revised definitions of invasive fungal disease from the EORTC/MSG clinical, microbiological and radiological criteria. Accordingly, the patients were diagnosed as having “proven,” “probable,” or “possible” IPA.For this, a Clinical data including clinical manifestations, diagnostic results, and treatment was collected for every patient.
Results
We analyzed 247 patients with acute leukemia. IPA was diagnosed in 57 patients .the incidence of IPA was 23% during 5 years. The average age was 29 years old (3 - 53 years old). All our patients had at least 3 criteria according to EORTC/MSG (neutropenia <500 / mm3 and prolonged, fever despite broad-spectrum antibiotics and immunosuppressive agents in the previous 30 days). The aspergillus antigenemia was positive in 26 patients (45%).The broncho-alveolar lavage (LBA) was done in 22 cases including (38%). For this, patients with aspergillosis were diagnosed with probable IPA in 45%, possible IPA in 46.5% and proven one in 5 cases (8.5%). All patients were treated with amphotericin B and relay by voriconazole. The Evolution was favorable in 28 cases (49%) with early deaths in 10 patients (18%). Twenty patients (35%) are alive with an average decline about 1 year.
Summary
The prevalence of the IPA in our series is higher than the literature (15%) because patients are treated in conventional rooms. The prevalence of proven IPA in our study is very low because of the difficulty of histological documentation (technic problem and deep thrombocytopenia) .Wherever; the precocity of diagnosis by TDM imagery and the treatment with voriconazole have improved the mortality rate in our series.
Keyword(s): Acute leukemia, Aspergillus, Voriconazole
Session topic: Publication Only
Abstract: PB1801
Type: Publication Only
Background
Invasive pulmonary aspergillosis (IPA) is a serious fungal infection and it’s associated with high mortality.
Aims
In this study, we evaluate the incidence and treatment outcome of IPA in acute leukemia (AL).
Methods
Our retrospective study included patients with novo acute leukemia (ALL or AML) under which occurring IPA during chemotherapy following in department of Hematology CHU Hédi CHaker Sfax between January 2009 and December 2013. The treatment of acute leukemia is based in chemotherapy and /or corticosteroids, and it is done in conventional rooms.Invasive pulmonary aspergillosis was diagnosed based on the revised definitions of invasive fungal disease from the EORTC/MSG clinical, microbiological and radiological criteria. Accordingly, the patients were diagnosed as having “proven,” “probable,” or “possible” IPA.For this, a Clinical data including clinical manifestations, diagnostic results, and treatment was collected for every patient.
Results
We analyzed 247 patients with acute leukemia. IPA was diagnosed in 57 patients .the incidence of IPA was 23% during 5 years. The average age was 29 years old (3 - 53 years old). All our patients had at least 3 criteria according to EORTC/MSG (neutropenia <500 / mm3 and prolonged, fever despite broad-spectrum antibiotics and immunosuppressive agents in the previous 30 days). The aspergillus antigenemia was positive in 26 patients (45%).The broncho-alveolar lavage (LBA) was done in 22 cases including (38%). For this, patients with aspergillosis were diagnosed with probable IPA in 45%, possible IPA in 46.5% and proven one in 5 cases (8.5%). All patients were treated with amphotericin B and relay by voriconazole. The Evolution was favorable in 28 cases (49%) with early deaths in 10 patients (18%). Twenty patients (35%) are alive with an average decline about 1 year.
Summary
The prevalence of the IPA in our series is higher than the literature (15%) because patients are treated in conventional rooms. The prevalence of proven IPA in our study is very low because of the difficulty of histological documentation (technic problem and deep thrombocytopenia) .Wherever; the precocity of diagnosis by TDM imagery and the treatment with voriconazole have improved the mortality rate in our series.
Keyword(s): Acute leukemia, Aspergillus, Voriconazole
Session topic: Publication Only
Type: Publication Only
Background
Invasive pulmonary aspergillosis (IPA) is a serious fungal infection and it’s associated with high mortality.
Aims
In this study, we evaluate the incidence and treatment outcome of IPA in acute leukemia (AL).
Methods
Our retrospective study included patients with novo acute leukemia (ALL or AML) under which occurring IPA during chemotherapy following in department of Hematology CHU Hédi CHaker Sfax between January 2009 and December 2013. The treatment of acute leukemia is based in chemotherapy and /or corticosteroids, and it is done in conventional rooms.Invasive pulmonary aspergillosis was diagnosed based on the revised definitions of invasive fungal disease from the EORTC/MSG clinical, microbiological and radiological criteria. Accordingly, the patients were diagnosed as having “proven,” “probable,” or “possible” IPA.For this, a Clinical data including clinical manifestations, diagnostic results, and treatment was collected for every patient.
Results
We analyzed 247 patients with acute leukemia. IPA was diagnosed in 57 patients .the incidence of IPA was 23% during 5 years. The average age was 29 years old (3 - 53 years old). All our patients had at least 3 criteria according to EORTC/MSG (neutropenia <500 / mm3 and prolonged, fever despite broad-spectrum antibiotics and immunosuppressive agents in the previous 30 days). The aspergillus antigenemia was positive in 26 patients (45%).The broncho-alveolar lavage (LBA) was done in 22 cases including (38%). For this, patients with aspergillosis were diagnosed with probable IPA in 45%, possible IPA in 46.5% and proven one in 5 cases (8.5%). All patients were treated with amphotericin B and relay by voriconazole. The Evolution was favorable in 28 cases (49%) with early deaths in 10 patients (18%). Twenty patients (35%) are alive with an average decline about 1 year.
Summary
The prevalence of the IPA in our series is higher than the literature (15%) because patients are treated in conventional rooms. The prevalence of proven IPA in our study is very low because of the difficulty of histological documentation (technic problem and deep thrombocytopenia) .Wherever; the precocity of diagnosis by TDM imagery and the treatment with voriconazole have improved the mortality rate in our series.
Keyword(s): Acute leukemia, Aspergillus, Voriconazole
Session topic: Publication Only
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