Acute myelogenous leukemia patients are at low risk for invasive fungal infections after high-dose cytarabine consolidations and thus do not require prophylaxis

Grant Lewis, Patricia Hall, Nihal Eisa, David Deremer, Robin Dobbins, Mohamed El-Geneidy, Anand Jillella, Celalettin Ustun

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

We evaluated the frequency of invasive fungal infections (IFI), the frequency of empirical antifungal use (EAFU), and the efficacy of fluconazole prophylaxis on IFI and EAFU after high-dose cytarabine (HiDAC) consolidations. Twenty-seven acute myelogenous leukemia patients in their first complete remission received 76 cycles of HiDAC (median cycle: n = 3). Fluconazole prophylaxis was administered following 44 cycles (fluconazole group) and not given in 32 cycles (control group). IFI (2 episodes) + EAFU (11 episodes) was observed in 13 of 76 cycles (17%); there was no difference between the fluconazole group and the control group (p = 0.469). Neutropenia duration was <13 days in 89% of the 76 cycles and was similar in the fluconazole and control groups (p = 0.845). Neutropenic fever was observed in 34 of the 76 cycles (45%) and was similar in the fluconazole group and the control group (p = 0.43). Although HiDAC cycle 1 was associated with a shorter neutropenia duration, there was no association between HiDAC cycle numbers and neutropenic fever or IFI + EAFU. HiDAC consolidations resulted in a high rate of neutropenic fever, the lack of an appreciable benefit from EAFU, and rare IFI. Most likely because of the low incidence of IFI, use of fluconazole or another antifungal is not warranted in this setting.

Original languageEnglish (US)
Pages (from-to)206-213
Number of pages8
JournalActa Haematologica
Volume124
Issue number4
DOIs
Publication statusPublished - Dec 1 2010

    Fingerprint

Keywords

  • Acute myelogenous leukemia
  • Antifungal prophylaxis
  • Fluconazole
  • High-dose cytarabine
  • Invasive fungal infections

ASJC Scopus subject areas

  • Hematology

Cite this