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Related Experiment Videos

Chronic systemic candidiasis in acute leukemia.

J Blade1, A Lopez-Guillermo, C Rozman

  • 1Postgraduate School of Hematology Ferreras Valentí, University of Barcelona, Spain.

Annals of Hematology
|May 1, 1992
PubMed
Summary
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Chronic systemic candidiasis (CSC) is an invasive Candida infection affecting neutropenic patients, particularly those with acute leukemia (AL). Early diagnosis and treatment with antifungals lead to resolution and do not prevent further cancer therapy.

Area of Science:

  • Mycology
  • Hematology
  • Infectious Diseases

Background:

  • Invasive Candida infections, specifically hepatosplenic or chronic systemic candidiasis (CSC), are increasingly recognized in neutropenic patients.
  • CSC has been observed with notable frequency in acute leukemia (AL) patients.

Purpose of the Study:

  • To describe the incidence, clinical features, diagnosis, and outcomes of chronic systemic candidiasis (CSC) in acute leukemia (AL) patients.
  • To differentiate CSC occurrence in AL patients compared to other hematological conditions.

Main Methods:

  • Retrospective analysis of 10 AL patients diagnosed with CSC between January 1985 and December 1990.
  • Clinical evaluation, laboratory tests (leukocyte count, alkaline phosphatase), imaging (CT, ultrasound), and liver biopsy were used for diagnosis.

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  • Treatment involved amphotericin B, 5-fluorocytosine, and in some cases, fluconazole.

    • Main Results:

    • Ten out of 305 AL patients were diagnosed with CSC; no cases were seen in 277 other hematological disease patients, including bone marrow transplant recipients.
    • Common symptoms included fever and hepatomegaly; abdominal pain was reported in five patients.
    • Diagnostic findings included neutrophilic leukocytosis, elevated alkaline phosphatase, characteristic lesions on CT/ultrasound, and granulomas with yeasts/pseudohyphae on liver biopsy.
    • All patients received antifungal therapy (amphotericin B, 5-fluorocytosine, fluconazole).

    Conclusions:

    • Chronic systemic candidiasis (CSC) is a significant invasive fungal infection predominantly seen in acute leukemia (AL) patients.
    • Prompt diagnosis and antifungal treatment are effective, with no direct mortality from CSC and successful resolution in most cases.
    • Controlled CSC does not impede subsequent intensive antileukemic therapy, including bone marrow transplantation.