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[Fungal infections in leukemic patients: our experience during 5 years]
M A Torre1, R Escalante, J C López Martín
1Servicio de Hematología y Hemoterapia, Hospital Universitario de Valme, Sevilla.
Abstract:
The use of high-dose chemotherapy and the subsequent prolonged neutropenia in patients with haematological diseases have resulted in an increased incidence of fungal infections. These infections are associated with a high mortality rate. There are several predisposing factors including broad-spectrum antibiotic, central venous access. Diagnosis remains difficult. Characteristic clinical manifestations are not constant and they appear only after neutrophil recovery. Responsible organisms are infrequently isolated. The use of invasive procedures is far from being justified in patients who suffering usual severe thrombocytopenia. The unique drug with proven efficiency in the treatment of fungal infections is amphotericin B or liposomal amphotericin B. A favourable outcome strongly correlated with complete leukemia remission. We describe our findings in seven leukemic patients with fungal infections.
Insights
High-dose chemotherapy increases fungal infections in leukemia patients, often leading to high mortality. Early diagnosis and treatment with amphotericin B are crucial for survival, especially with leukemia remission.
Area of Science:
- Hematology
- Mycology
- Infectious Diseases
Context:
- High-dose chemotherapy for hematological diseases causes prolonged neutropenia.
- This immunosuppression significantly increases the risk of invasive fungal infections.
- Fungal infections in these patients are associated with a high mortality rate.
Purpose:
- To investigate the incidence, diagnosis, and treatment of fungal infections in leukemic patients undergoing chemotherapy.
- To highlight the challenges in diagnosing and managing these infections.
- To present findings from seven cases of fungal infections in leukemic patients.
Summary:
- Prolonged neutropenia post-chemotherapy predisposes hematological patients to fungal infections.
- Diagnosis is challenging due to non-specific symptoms and difficulty in isolating causative organisms.
- Amphotericin B or liposomal amphotericin B are the primary treatments, with outcomes correlating with leukemia remission.
Impact:
- Underscores the critical need for vigilant monitoring and prompt management of fungal infections in immunocompromised leukemia patients.
- Informs clinical practice regarding diagnostic challenges and therapeutic strategies.
- Emphasizes the importance of achieving leukemia remission for successful fungal infection treatment.