A Grateau1, M Le Maréchal2, H Labussière-Wallet1, S Ducastelle-Leprêtre1, F-E Nicolini1, X Thomas1, S Morisset1, M Michallet3, F Ader4. 1. Département d'hématologie, centre hospitalier Lyon-Sud, hospices civils de Lyon, 69495 Pierre-Bénite, France. 2. Université de Lorraine, EA 4360 APEMAC, Nancy, France; Département de santé publique, CHU de Nice, Nice, France. 3. Département d'hématologie, centre hospitalier Lyon-Sud, hospices civils de Lyon, 69495 Pierre-Bénite, France; Département de maladies infectieuses et tropicales, hospices civils de Lyon, 69004 Lyon, France. 4. Département de maladies infectieuses et tropicales, hospices civils de Lyon, 69004 Lyon, France; Inserm U1111 CIRI, université Claude-Bernard-Lyon 1, Lyon, France. Electronic address: florence.ader@chu-lyon.fr.
Abstract
OBJECTIVES: To study the management of chronic disseminated candidiasis (CDC) in patients presenting with acute leukemia. PATIENTS AND METHODS: Single-center retrospective study of acute leukemia patients (2006-2015) to investigate three aspects of CDC: its impact on the time interval between diagnosis and hematopoietic stem cell transplantation, when required (non-parametric Wilcoxon-Mann-Whitney test); its impact on overall survival (Cox proportional hazard regression model); antifungal therapeutic strategies implemented. RESULTS: A total of 639 patients presenting with acute leukemia were included; 144 were transplanted and 29 developed CDC. CDC did not significantly increase the time interval between diagnosis and transplantation, nor did it impact the overall survival of recipients. An improved overall survival was observed in non-transplanted acute leukemia patients presenting with CDC. CONCLUSION: CDC should not postpone transplantation if antifungal treatment is optimized.
OBJECTIVES: To study the management of chronic disseminated candidiasis (CDC) in patients presenting with acute leukemia. PATIENTS AND METHODS: Single-center retrospective study of acute leukemiapatients (2006-2015) to investigate three aspects of CDC: its impact on the time interval between diagnosis and hematopoietic stem cell transplantation, when required (non-parametric Wilcoxon-Mann-Whitney test); its impact on overall survival (Cox proportional hazard regression model); antifungal therapeutic strategies implemented. RESULTS: A total of 639 patients presenting with acute leukemia were included; 144 were transplanted and 29 developed CDC. CDC did not significantly increase the time interval between diagnosis and transplantation, nor did it impact the overall survival of recipients. An improved overall survival was observed in non-transplanted acute leukemiapatients presenting with CDC. CONCLUSION: CDC should not postpone transplantation if antifungal treatment is optimized.