Fungemia in Hospitalized Adult Patients with Hematological Malignancies: Epidemiology and Risk Factors

• Published in: Journal of fungi (Basel) Vol. 9; no. 4; p. 400
• Main Authors: Vargas-Espíndola, Luz Alejandra, Cuervo-Maldonado, Sonia I, Enciso-Olivera, José L, Gómez-Rincón, Julio C, Jiménez-Cetina, Leydy, Sánchez-Pedraza, Ricardo, García-Guzmán, Katherine, López-Mora, María José, Álvarez-Moreno, Carlos A, Cortés, Jorge Alberto, Garzón-Herazo, Javier R, Martínez-Vernaza, Samuel, Sierra-Parada, Claudia R, Murillo-Sarmiento, Bryan A
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 24-03-2023; MDPI
• Subjects: Cancer; Cancer therapies; Candida; candidemia; Catheters; Chemotherapy; Colombia; Disease prevention; Epidemiology; Fungemia; Health aspects; hematologic malignancy; Hematology; Hospitals; Immune system; Infections; International organizations; Latin America; leukemia; Lymphoma; Lymphomas; Malignancy; Mortality; Multiple myeloma; Neutropenia; Oncology; Population; Posaconazole; Prophylaxis; Risk factors; Statistical analysis; Transplants & implants; Yeast; Colombia; Latin America; United States > US; leukemia; myeloma; Candida; lymphoma; mortality; fungemia; candidemia; hematologic malignancy
• ISSN: 2309-608X; 2309-608X
• DOI: 10.3390/jof9040400

Fungemia in hematologic malignancies (HM) has high mortality. This is a retrospective cohort of adult patients with HM and fungemia between 2012 and 2019 in institutions of Bogotá, Colombia. The epidemiological, clinical, and microbiological characteristics are described, and risk factors related to mortality are analyzed. One hundred five patients with a mean age of 48 years (SD 19.0) were identified, 45% with acute leukemia and 37% with lymphomas. In 42%, the HM was relapsed/refractory, 82% ECOG > 3, and 35% received antifungal prophylaxis; 57% were in neutropenia, with an average duration of 21.8 days. In 86 (82%) patients,
spp. was identified, and other yeasts in 18%. The most frequent of the isolates were non-albicans
(61%),
(28%),
(17%), and
(12%). The overall 30-day mortality was 50%. The survival probability at day 30 in patients with leukemia vs. lymphoma/multiple myeloma (MM0 group was 59% (95% CI 46-76) and 41% (95% CI 29-58),
= 0.03, respectively. Patients with lymphoma or MM (HR 1.72; 95% CI 0.58-2.03) and ICU admission (HR 3.08; 95% CI 1.12-3.74) were associated with mortality. In conclusion, in patients with HM, non-albicans
species are the most frequent, and high mortality was identified; moreover, lymphoma or MM and ICU admission were predictors of mortality.