Incidence and Management of Proven and Probable Fungal Infections in Patients with Acute Leukemia: A Single Center Experience

Abstract

The incidence of fungal infections and the role of liposomal amphotericin B (Ambisome) in proven and probable infections were evaluated in acute leukemic patients, intolerant to conventional amphotericin B. During 1999-2002, 307 febrile episodes occurred in 231 patients. Fungi were responsible for 3% of bloodstream infections. Ambisome was employed in 5 fungal sepsis (1 Candida albicans, 1 C. famata, 1 C. tropicalis, 1 C. krusei, 1 Geotrichum capitatum) 2 Aspergillosis, 2 probable fungal pneumonia cases. A favorable response was achieved in 78% of patients (4 fungemia, 2 aspergillosis, 1 probable), an unfavorable response in 1 C. krusei fungemia and in 1 probable pneumonia. Our antimicrobial pattern docu-mented a high resistance rate to azoles. We concluded that Ambisome is an effec-tive and well tolerated agent and its introduction has changed the outcome for many patients, although in some refractory diseases other strategies must be con-sidered.

Keywords:

• Fungal infection
• acute leukemia
• cancer patient
• Ambisome
• liposo-mal amphotericin B