Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA.
Leuk Lymphoma. 2022 Aug;63(8):1934-1941. doi: 10.1080/10428194.2022.2047964. Epub 2022 Mar 15.
Antifungal prophylaxis (AFP) is recommended for acute myeloid leukemia (AML) patients receiving the combination of venetoclax (VEN) and a hypomethylating agent (HMA), but the benefit of this practice is unclear. We identified 131 patients with newly diagnosed AML who received frontline VEN/HMA and evaluated the use of AFP and its association with invasive fungal infections (IFIs) and AML outcomes. Seventeen percent of our patients received AFP at any time. Overall incidence of any IFI ('possible,' 'probable,' or 'proven' infection, as defined by the European Mycoses Study Group) was 13%, and the incidence did not differ based on AFP use (=.74). Median overall survival did not differ based on AFP use or lack thereof (8.1 vs. 12.5 months, respectively; =.14). Our findings suggest that, at an institution where the incidence of fungal infections is low, there does not appear to be a role for AFP in newly diagnosed AML patients receiving VEN/HMA.
抗真菌预防（AFP）被推荐用于接受 venetoclax（VEN）和低甲基化药物（HMA）联合治疗的急性髓细胞白血病（AML）患者，但这种做法的益处尚不清楚。我们确定了 131 例接受一线 VEN/HMA 治疗的新诊断为 AML 的患者，并评估了 AFP 的使用情况及其与侵袭性真菌感染（IFI）和 AML 结局的关系。我们的患者中有 17%在任何时候都接受了 AFP。任何 IFI（根据欧洲真菌感染研究组的定义，为“可能”、“可能”或“确诊”感染）的总体发生率为 13%，且 AFP 使用与否与 IFI 发生率无差异（=0.74）。根据 AFP 的使用或不使用，总生存中位数无差异（分别为 8.1 个月和 12.5 个月；=0.14）。我们的研究结果表明，在真菌感染发生率较低的机构中，对于接受 VEN/HMA 治疗的新诊断 AML 患者，AFP 的作用似乎并不存在。
