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https://hdl.handle.net/2440/72986
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dc.contributor.author | Khalafallah, A. | - |
dc.contributor.author | Maiwald, M. | - |
dc.contributor.author | Hannan, T. | - |
dc.contributor.author | Abell, S. | - |
dc.contributor.author | Staker, L. | - |
dc.contributor.author | Supperamohan, A. | - |
dc.date.issued | 2012 | - |
dc.identifier.citation | Internal Medicine Journal, 2012; 42(2):131-136 | - |
dc.identifier.issn | 1444-0903 | - |
dc.identifier.issn | 1445-5994 | - |
dc.identifier.uri | http://hdl.handle.net/2440/72986 | - |
dc.description.abstract | Background: Mortality related to induction chemotherapy during the treatment of acute leukaemias (AL) has been estimated at 5–20%, and this increases with age. Fungal infection remains one of the major causes of morbidity and mortality and is considered an obstacle to the successful management of acute leukaemias. Methods: We retrospectively analysed all patients treated for acute leukaemias at a single institution between July 2006 and January 2009, to assess the impact of early antifungal therapy on outcome during induction chemotherapy. There were 44 episodes of induction chemotherapy, with a median age of patients of 61 years (range 18–81), including 29 patients with acute myeloid leukaemia, 9 with acute lymphoblastic leukaemia and 6 with relapsed AL. The median age was 61 years (range 18–81), and 20 patients were over the age of 60 years. Results: All patients who developed febrile neutropenia received broad-spectrum antibiotics. Early empirical antifungal treatment was commenced with voriconazole (15 patients) or caspofungin (12 patients) if the febrile neutropenia did not resolve after 72 h of antibiotic therapy, in conjunction with radiological changes consistent with possible fungal infection. None of the patients succumbed during induction chemotherapy. The 120-day mortality rate after the induction therapy was 2.2%, without any incidence of invasive fungal disease. Conclusion: Our analysis shows that early empirical treatment for fungal infection with voriconazole or caspofungin is associated with a favourable outcome of induction therapy for acute leukaemias. Further studies to confirm this finding are warranted. | - |
dc.description.statementofresponsibility | A. Khalafallah, M. Maiwald, T. Hannan, S. Abell, J. Staker and A. Supperamohan | - |
dc.language.iso | en | - |
dc.publisher | Blackwell Publishing Asia | - |
dc.rights | © 2011 The Authors | - |
dc.source.uri | http://dx.doi.org/10.1111/j.1445-5994.2011.02638.x | - |
dc.subject | acute leukaemia | - |
dc.subject | induction chemotherapy | - |
dc.subject | fungal infection | - |
dc.subject | empirical | - |
dc.subject | outcome. | - |
dc.title | Early implementation of antifungal therapy in the management of febrile neutropenia is associated with favourable outcome during induction chemotherapy for acute leukaemias | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1111/j.1445-5994.2011.02638.x | - |
pubs.publication-status | Published | - |
Appears in Collections: | Aurora harvest Medicine publications |
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