Related Experiment Video
Updated: Mar 10, 2026
Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
Invasive aspergillosis in acute myeloid leukemia: Are we making progress in reducing mortality?
Giulia Dragonetti1, Marianna Criscuolo2, Luana Fianchi2
1Hematology Department, Catholic University of Sacred Heart, Rome, Italy dragonettigiulia@gmail.com.
Abstract:
The incidence of invasive fungal disease (IFD) has varied during the last decades. However, over the years, we have observed a progressive reduction of mortality, mainly due to wider use of prophylactic antifungal therapy (i.e., new azoles, such as posaconazole), the development of new and more effective antifungal drugs (lipid compounds of amphotericin B, candins, and azoles of the previous generation) and improvement of diagnostic tools. Based on a number of international studies across three decades, the attributable mortality rate for IFD and invasive aspergillosis (IA) among patients with acute myeloid leukemia (AML) has progressively declined. In the first report, in 2001, the attributable mortality rate for aspergillosis observed in AML patients by the GIMEMA (Gruppo Italiano Malattie Ematologiche Maligne dell'Adulto) group was near 60%. A subsequent multicenter Italian study by SEIFEM (Sorveglianza Epidemiologica Infezioni Fungine nelle Emopatie Maligne) reported an attributable mortality of 38% among 3,012 patients recruited from 1999 through 2003. Further reduction to 27% was reported for patients diagnosed between 2004 and 2007 in another SEIFEM study. Over the last few years, a different trend in mortality for IA has been observed in the various phases of therapy in patients with acute leukemia: while in the induction phase of treatment, characterized by a higher incidence of IA, we observed a reduction of mortality over the years, among relapsed/refractory patients, the mortality remains dramatically high.
Insights
Mortality from invasive fungal disease (IFD) in acute myeloid leukemia (AML) patients has decreased due to better antifungal therapies and diagnostics. However, high mortality persists in relapsed/refractory cases.
Area of Science:
- Mycology
- Hematology
- Infectious Diseases
Background:
- Invasive fungal disease (IFD) incidence has fluctuated, but mortality has decreased over decades.
- Advances in antifungal therapies (posaconazole, lipid amphotericin B, echinocandins) and diagnostics have improved outcomes.
- Attributable mortality for IFD and invasive aspergillosis (IA) in acute myeloid leukemia (AML) patients has progressively declined.
Purpose of the Study:
- To analyze the trend of mortality rates for IFD and IA in AML patients over three decades.
- To evaluate the impact of improved antifungal treatments and diagnostics on IFD mortality in AML.
- To identify specific patient groups within AML therapy where mortality remains high.
Main Methods:
- Review of international studies spanning three decades.
- Analysis of attributable mortality rates for IFD and IA in AML patients.
- Comparison of mortality trends across different treatment phases (induction vs. relapsed/refractory).
Main Results:
- Attributable mortality for IA in AML patients decreased from nearly 60% in 2001 to 27% in studies from 2004-2007.
- Significant reductions in IA mortality observed during the induction phase of AML treatment.
- Persistently high and dramatic mortality rates for IA in relapsed/refractory AML patients.
Conclusions:
- Improved prophylactic antifungal therapy and diagnostics have substantially reduced IFD/IA mortality in AML patients.
- While overall mortality has declined, invasive aspergillosis remains a critical challenge in relapsed/refractory AML.
- Further research and therapeutic strategies are needed for high-risk AML patient subgroups.
