Effect of invasive aspergillosis on risk for different causes of death in older patients with acute myeloid leukaemia or high-risk myelodysplastic syndrome

BMC Infectious Diseases

Research

Dana A. Chitu¹  Peter A. von dem Borne²  Nicole M. A. Blijlevens³  Mark G. J. de Boer⁴  Martha T. van der Beek⁵  Rebecca van Grootveld⁵  Valentina Masarotto⁶  Marta Fiocco⁷ 

[1] Department of Haematology, Erasmus University Medical Center, Rotterdam, The Netherlands;Department of Haematology, Leiden University Medical Center, Leiden, The Netherlands;Department of Haematology, Radboud University Medical Center, Nijmegen, The Netherlands;Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands;Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands;Mathematical Institute, Leiden University, Leiden, The Netherlands;Mathematical Institute, Leiden University, Leiden, The Netherlands;Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands;

关键词: Aspergillosis;    Invasive pulmonary aspergillosis;    Invasive fungal infection;    Acute myeloid leukaemia;    Myelodysplastic syndromes;    Aged;   

DOI  :  10.1186/s12879-023-08013-5

 received in 2022-08-15, accepted in 2023-01-18,  发布年份 2023

来源: Springer

【 摘 要 】

PurposeStudy objectives were to estimate the cumulative incidence of death due to different causes of death (CODs) and investigate the effect of invasive aspergillosis (IA) on each separate COD in a cohort of older patients with acute myeloid leukaemia (AML) or high-risk myelodysplastic syndrome (MDS) included in the Haemato-Oncology Foundation for Adults in the Netherlands (HOVON) 43 randomized controlled trial.MethodsPre-collected data from the trial was obtained from the HOVON data center and relevant clinical information was extracted. The cumulative incidence of death due to different CODs was estimated with a competing risk model and the association between each COD and prognostic factors, including IA, were investigated with a cause-specific hazard Cox regression model.ResultsIn total 806 patients were included, mean age of 70 years and 55% were male. The cumulative incidences of death due to leukaemia or infection at 3, 6, 12 and 36 months were 0.06, 0.11, 0.23, 0.42 and 0.17, 0.19, 0.22, 0.25 respectively. Incidence of IA was 21% and diagnosis of IA up until the final chemotherapy cycle was associated with an increased risk of dying from leukaemia (cause-specific hazard ratio (CSHR): 1.75, 95% CI 1.34–2.28) and a trend was seen for infection (CSHR: 1.36, 95% CI 0.96–1.91).ConclusionLeukaemia was the most likely cause of death over time, however in the first year after diagnosis of AML or high-risk MDS infection was the most likely cause of death. Patients with IA had a relatively increased risk of dying from leukaemia or infection.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 4