Fungemia in acute leukemia patients: a single institution's experience

A retrospective study was conducted in 22 episodes of candidemia in 445 patients with acute leukemia (AL) (incidence 4.9%) observed at our Institution between February 1996 and November 2003 to evaluate the variables related to the onset and outcome of infection. Of 22 patients, 20 (90.9%) had refractory/relapsed AL. C. albicans was responsible for 7/22 of the fungemia cases (32%) and C. non albicans for 15/22 (68%). The median absolute neutrophil count was 0.1 x10(9)/L (range 0.04-0.3) at the time of the candidemia diagnosis. The fungemia responded to antifungal therapy in 15/22 (68.1%) patients; among patients with a positive outcome of the fungemia, in 14/15 (93.3%) the neutrophil count recovered within 7 days after the diagnosis of candidemia (p < 0.05). The mortality rate due to candidemia was 31.9% (1/7: 14.2% and 6/15: 40% in the C. albicans and C. non albicans groups, respectively). In our experience the determinants of a positive outcome of fungemia were infection by the C. albicans species and recovery of the neutrophil count.