Département d'hématologie, centre hospitalier Lyon-Sud, hospices civils de Lyon, 69495 Pierre-Bénite, France.
Université de Lorraine, EA 4360 APEMAC, Nancy, France; Département de santé publique, CHU de Nice, Nice, France.
Med Mal Infect. 2018 May;48(3):202-206. doi: 10.1016/j.medmal.2017.12.004. Epub 2018 Jan 4.
To study the management of chronic disseminated candidiasis (CDC) in patients presenting with acute leukemia.
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.
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.
CDC should not postpone transplantation if antifungal treatment is optimized.
研究急性白血病患者中慢性播散性念珠菌病（CDC）的治疗管理。
对 2006 年至 2015 年期间的急性白血病患者进行单中心回顾性研究，以调查 CDC 的三个方面：它对诊断和造血干细胞移植之间时间间隔的影响（非参数 Wilcoxon-Mann-Whitney 检验）；它对总生存率的影响（Cox 比例风险回归模型）；实施的抗真菌治疗策略。
共纳入 639 例急性白血病患者，其中 144 例接受移植，29 例发生 CDC。CDC 并未显著延长诊断和移植之间的时间间隔，也未影响受者的总生存率。在出现 CDC 的未移植急性白血病患者中，观察到总生存率提高。
如果优化抗真菌治疗，CDC 不应该推迟移植。
