Sanna Marco, Caocci Giovanni, Ledda Antonio, Orrù Federica, Fozza Claudio, Deias Paola, Tidore Gianni, Dore Fausto, La Nasa Giorgio
a Hematology Unit, Department of Medical Sciences and Public Health , Bone Marrow Transplant Center, R. Binaghi Hospital, University of Cagliari , Cagliari , Italy.
b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy.
Leuk Lymphoma. 2017 Nov;58(11):2558-2564. doi: 10.1080/10428194.2017.1312666. Epub 2017 Apr 12.
Invasive fungal diseases (IFD) are still a leading cause of morbidity and mortality in patients with acute myeloid leukemia (AML). Glucose-6-phosphate dehydrogenase is an enzyme that leads to the production of NADPH, required to destroy microorganisms in the respiratory burst reaction of white blood cells. We evaluated the role of G6PD deficiency in susceptibility of IFD in 108 AML patients undergoing intensive chemotherapy. In all, 28 patients harbored G6PD deficiency (G6PD-), whereas 80 were normal (G6PD +). Incidence of IFD was significantly higher in G6PD- patients compared to G6PD + patients (35.7% vs. 5%, p = .0002, OR = 10, 95% CI = 2.96-37.5). Higher risk of mold infections (17.9% vs. 5%, p = .048, OR = 4.1, 95% CI = 1.0-16.6) and Candida sepsis (17.9% vs. 0%, p = .0009, OR = 37.68, 95% CI =2.0-707.1) was observed in G6PD - patients. The evaluation of G6PD activity may help to identify AML patients at higher risk of IFD, allowing to design more intensive surveillance and therapeutic strategies.
侵袭性真菌病（IFD）仍然是急性髓系白血病（AML）患者发病和死亡的主要原因。葡萄糖-6-磷酸脱氢酶是一种可导致产生NADPH的酶，NADPH是白细胞呼吸爆发反应中杀灭微生物所必需的。我们评估了108例接受强化化疗的AML患者中G6PD缺乏在IFD易感性中的作用。总共有28例患者存在G6PD缺乏（G6PD-），而80例为正常（G6PD+）。与G6PD+患者相比，G6PD-患者的IFD发生率显著更高（35.7%对5%，p = 0.0002，OR = 10，95%CI = 2.96 - 37.5）。在G6PD-患者中观察到霉菌感染风险更高（17.9%对5%，p = 0.048，OR = 4.1，95%CI = 1.0 - 16.6）以及念珠菌败血症风险更高（17.9%对0%，p = 0.0009，OR = 37.68，95%CI = 2.0 - 707.1）。评估G6PD活性可能有助于识别IFD风险较高的AML患者，从而能够设计更强化的监测和治疗策略。
