eCite Digital Repository

Early implementation of antifungal therapy in the management of febrile neutropenia is associated with favourable outcome during induction chemotherapy for acute leukaemias

Citation

Khalafallah, A and Maiwald, M and Hannan, T and Abell, S and Staker, J and Supperamohan, A, Early implementation of antifungal therapy in the management of febrile neutropenia is associated with favourable outcome during induction chemotherapy for acute leukaemias, Internal Medicine Journal, 42, (2) pp. 131-136. ISSN 1444-0903 (2012) [Refereed Article]


Preview
PDF
Restricted - Request a copy
104Kb
  

Copyright Statement

The definitive published version is available online at: http://www3.interscience.wiley.com/

DOI: doi:10.1111/j.1445-5994.2011.02638.x

Abstract

Background:  Mortality related to induction chemotherapy during the treatment of acute leukaemias (AL) has been estimated at 5-20%, and this increases with age. Fungal infection remains one of the major causes of morbidity and mortality and is considered an obstacle to the successful management of acute leukaemias. Methods:  We retrospectively analysed all patients treated for acute leukaemias at a single institution between July 2006 and January 2009, to assess the impact of early antifungal therapy on outcome during induction chemotherapy. There were 44 episodes of induction chemotherapy, with a median age of patients of 61 years (range 18-81), including 29 patients with acute myeloid leukaemia, 9 with acute lymphoblastic leukaemia and 6 with relapsed AL. The median age was 61 years (range 18-81), and 20 patients were over the age of 60 years. Results:  All patients who developed febrile neutropenia received broad-spectrum antibiotics. Early empirical antifungal treatment was commenced with voriconazole (15 patients) or caspofungin (12 patients) if the febrile neutropenia did not resolve after 72 h of antibiotic therapy, in conjunction with radiological changes consistent with possible fungal infection. None of the patients succumbed during induction chemotherapy. The 120-day mortality rate after the induction therapy was 2.2%, without any incidence of invasive fungal disease. Conclusion:  Our analysis shows that early empirical treatment for fungal infection with voriconazole or caspofungin is associated with a favourable outcome of induction therapy for acute leukaemias. Further studies to confirm this finding are warranted.

Item Details

Item Type:Refereed Article
Keywords:acute leukaemia, induction chemotherapy,
Research Division:Medical and Health Sciences
Research Group:Oncology and Carcinogenesis
Research Field:Chemotherapy
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Blood Disorders
Author:Khalafallah, A (Professor Alhossain Khalafallah)
ID Code:76420
Year Published:2012
Web of Science® Times Cited:1
Deposited By:Health Sciences A
Deposited On:2012-03-06
Last Modified:2017-11-06
Downloads:0

Repository Staff Only: item control page