Pulmonary infections in patients with acute myeloid leukemia receiving frontline treatment with hypomethylating agents

Abstract

Pulmonary infections (PIs) are a major complication of Acute Myeloid Leukemia (AML) treated with hypomethylating agents (HMA). We retrospectively evaluated 147 AML patients treated frontline with HMA in 2 Centers. Total number of HMA cycles was 1397. There were 88 episodes of PI in 64 patients (43.5%). Thirty-five/147 patients at risk (23.8%) developed at least 1 episode of early PI (during cycles 1–2). Median OS in patients who developed early PI was 3.3 months (95% CI 0.8 − 5.8) versus 10.5 months (95% CI 8.4 − 12.7) in patients without PI or with PI beyond the 2nd cycle (p < .001). Early PIs were an independent factor predicting lower survival (OR 1.94, 95% CI 1.28 − 2.93; p = .002). In conclusion, early PIs are common in AML patients receiving HMA and are associated with an unfavorable outcome. The results of our study raise the issue of a tailored infection prevention strategy.

Keywords:

• Acute myeloid leukemia
• hypomethylating agents
• pulmonary infections

Ethical statement

The study was conducted according to the guidelines of CONSORT (Consolidated Standards of Reporting Trials) and approved by the IRB.

Disclosure statement

R.L. honoraria by Novartis, BMS-Cellgene, Janssen and Pfizer; M.B. honoraria by Novartis, BMS-Cellgene, Abbvie; all other Authors have no conflict of interest to declare.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This study had no funding to declare.