Candidemia in acute leukemia patients

Area of Science:

• Infectious Diseases
• Hematology
• Oncology

Background:

• Fungal infections pose a significant threat to patients with acute leukemia (AL).
• Candidemia has become a common nosocomial infection in AL patients due to intensive chemotherapy, prolonged neutropenia, broad-spectrum antibiotics, and central venous catheters (CVC).

Purpose of the Study:

• To retrospectively analyze the incidence, clinical presentation, treatment, and outcomes of candidemia in patients with acute leukemia.

Main Methods:

• Retrospective identification of 28 AL patients with candidemia between June 1986 and June 1995.
• Review of patient demographics, treatment regimens (including CVC, antimicrobial and antifungal therapies, parenteral nutrition), neutropenia status, clinical symptoms, and outcomes.

Main Results:

• The incidence of candidemia was 6.3% among AL patients.
• Patients experienced profound neutropenia (median 200 cells/microliter for 19 days).
• Common symptoms included fever (100%), respiratory issues (71.4%), skin lesions (39.2%), and septic shock (17.8%).
• Amphotericin B was the primary treatment.
• Infection resolved in 64.2% of patients, with 10 achieving complete remission.
• Mortality directly attributed to candidemia was 17.8%.

Conclusions:

• Fungal infections contribute significantly to mortality in acute leukemia patients.
• Prompt initiation of antifungal treatment and recovery of neutropenia are crucial for successful outcomes in candidemia.