Department of Pharmacy, Stanford Health Care, Stanford, CA, USA.
Department of Pharmaceutical Services, University of California, San Francisco Health, San Francisco, CA, USA.
Br J Haematol. 2022 Apr;197(1):63-70. doi: 10.1111/bjh.18051. Epub 2022 Feb 16.
We investigated the incidence of invasive fungal infections (IFIs) and other infectious complications in patients receiving venetoclax and hypomethylating agent therapy for acute myeloid leukaemia (AML). This retrospective, multicentre cohort study included adult patients with AML who received at least one cycle of venetoclax and either azacitidine or decitabine between January 2016 and August 2020. The primary outcome was the incidence of probable or confirmed IFI. Secondary outcomes included antifungal prophylaxis prescribing patterns, incidence of bacterial infections, and incidence of neutropenic fever hospital admissions. Among 235 patients, the incidence of probable or confirmed IFI was 5.1%. IFI incidence did not differ significantly according to age, antifungal prophylaxis use, or disease status. In the subgroup of patients with probable or confirmed IFIs, six (50%) were receiving antifungal prophylaxis at the time of infection. The overall incidence of developing at least one bacterial infection was 33.6% and 127 (54%) patients had at least one hospital admission for febrile neutropenia. This study demonstrated an overall low risk of developing probable or confirmed IFI as well as a notable percentage of documented bacterial infections and hospital admissions due to neutropenic fever.
我们研究了接受 venetoclax 和低甲基化剂治疗急性髓系白血病(AML)的患者中侵袭性真菌感染(IFI)和其他感染性并发症的发生率。这项回顾性、多中心队列研究纳入了 2016 年 1 月至 2020 年 8 月期间接受至少一个周期 venetoclax 联合阿扎胞苷或地西他滨治疗的 AML 成年患者。主要结局是确定或疑似 IFI 的发生率。次要结局包括抗真菌预防用药模式、细菌感染的发生率和中性粒细胞减少性发热住院的发生率。在 235 例患者中,确定或疑似 IFI 的发生率为 5.1%。IFIs 的发生率与年龄、抗真菌预防用药和疾病状态无关。在确定或疑似 IFI 的患者亚组中,有 6 例(50%)在感染时正在接受抗真菌预防用药。至少发生一次细菌感染的总发生率为 33.6%,有 127 例(54%)患者至少因中性粒细胞减少性发热而有一次住院。本研究表明,发生确定或疑似 IFI 的总体风险较低,但有相当比例的细菌感染和中性粒细胞减少性发热导致的住院记录。