Identification of risk factors for hepatosplenic candidiasis in patients with acute leukemia

implications for prophylaxis

S. Sallah, Jim Wan

Research output: Contribution to journalArticle

Abstract

To better determine the presence of risk factors for the development of hepatosplenic candidiasis (HSC), we examined data on 423 patients with acute leukemia diagnosed between 1990 and 1998. There were 23 patients with HSC and 26 patients with acute leukemia identified during the study period. The following variables were included in 2 logistic regression analyses: age; mucositis; colonization with Candida; candiduria; duration of neutropenia; use of quinolones; concomitant infections and administration of high dose ara-C. According to multivariate analysis, young age (P = 009; odds ratio [OR] = .96; confidence interval [CI] = .93 - .99), duration of neutropenia > 15 days (P = .003; OR = 11.72; CI = 3.04 - 45.1) and use of quinolone antibiotics (P = .039; OR = 3.85; CI = . 11 13.4) were independent factors significantly related to the occurrence of HSC in patients with acute leukemia. Prolonged neutropenic phase > 15 days was the only independent factors that predicted the development of HSC in patients with confirmed candidemia (P = .002; OR = 48.48; CI = 3.91 - 60.1). Based on the results of this study, it is now possible to identify a subset of patients with acute leukemia at high risk for HSC. Because of the high morbidity of HSC, early initiation of antifungal agents in patients at risk may potentially prevent the occurrence of this complication, or at least, improve the control and outcome of the infection. The optimal agent or combination of antifungal agents and schedule of administration need to be examined in well-controlled trials.

Original languageEnglish (US)
JournalBlood
Volume96
Issue number11 PART II
StatePublished - 2000

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Candidiasis
Leukemia
Antifungal Agents
Quinolones
Odds Ratio
Confidence Intervals
Candida
Cytarabine
Set theory
Logistics
Neutropenia
Anti-Bacterial Agents
Candidemia
Mucositis
Infection Control
Appointments and Schedules
Multivariate Analysis
Logistic Models
Regression Analysis
Morbidity

All Science Journal Classification (ASJC) codes

  • Hematology

Cite this

Identification of risk factors for hepatosplenic candidiasis in patients with acute leukemia : implications for prophylaxis. / Sallah, S.; Wan, Jim.

In: Blood, Vol. 96, No. 11 PART II, 2000.

Research output: Contribution to journalArticle

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abstract = "To better determine the presence of risk factors for the development of hepatosplenic candidiasis (HSC), we examined data on 423 patients with acute leukemia diagnosed between 1990 and 1998. There were 23 patients with HSC and 26 patients with acute leukemia identified during the study period. The following variables were included in 2 logistic regression analyses: age; mucositis; colonization with Candida; candiduria; duration of neutropenia; use of quinolones; concomitant infections and administration of high dose ara-C. According to multivariate analysis, young age (P = 009; odds ratio [OR] = .96; confidence interval [CI] = .93 - .99), duration of neutropenia > 15 days (P = .003; OR = 11.72; CI = 3.04 - 45.1) and use of quinolone antibiotics (P = .039; OR = 3.85; CI = . 11 13.4) were independent factors significantly related to the occurrence of HSC in patients with acute leukemia. Prolonged neutropenic phase > 15 days was the only independent factors that predicted the development of HSC in patients with confirmed candidemia (P = .002; OR = 48.48; CI = 3.91 - 60.1). Based on the results of this study, it is now possible to identify a subset of patients with acute leukemia at high risk for HSC. Because of the high morbidity of HSC, early initiation of antifungal agents in patients at risk may potentially prevent the occurrence of this complication, or at least, improve the control and outcome of the infection. The optimal agent or combination of antifungal agents and schedule of administration need to be examined in well-controlled trials.",
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