Invasive Fungal Disease in Adults Undergoing Remission-Induction Therapy for Acute Myeloid Leukemia: The Pathogenetic Role of the Antileukemic Regimen

Objective The clinical characteristics and therapeutic strategy in acute myeloid leukemia (AML) are influenced by patients’ age. We evaluated the impact of age on remission induction therapy for AML. Methods We retrospectively analyzed 3,011 adult AML patients identified from a nationwide database between January 2007 and December 2011. Results Three hundred twenty-nine (10.9%) acute promyelocytic leukemia (APL) and 2,682 (89.1%) non-APL patients were analyzed. The median age was 51 years and 55% of patients were male. Six hundred twenty-three patients (21%) were at favorable risk, 1522 (51%) were at intermediate risk, and 743 (25%) were at poor risk. As the age increased, the proportion of those at favorable risk and who received induction chemotherapy decreased. After induction therapy, complete response (CR) was achieved in 81.5% (243/298) of APL and 62.4% (1,409/2,258) of non-APL patients; these rates decreased as the age increased, with an obvious decrement in those older than 60 years. The median overall survival of non-APL patients was 18.7 months, while that of APL patients was not reached, with a 75% five-year survival rate. Conclusions Age impacts both the biology and clinical outcomes of AML patients. Further studies should confirm the role of induction remission chemotherapy by age group.

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Poster: AML-202: A Single-Center Comparative Clinical Study of Prophylactic Antifungal Therapy of Voriconazole versus Posaconazole in Patients with Acute Myeloid Leukemia Undergoing Remission-Induction Therapy

Clinical Lymphoma Myeloma & Leukemia ◽

10.1016/s2152-2650(21)01325-2 ◽

2021 ◽

Vol 21 ◽

pp. S211

Author(s):

Asif Iqbal ◽

Saikat Datta ◽

Maitreyee Bhattacharyya

Keyword(s):

Acute Myeloid Leukemia ◽

Clinical Study ◽

Antifungal Therapy ◽

Induction Therapy ◽

Myeloid Leukemia ◽

Remission Induction ◽

Single Center ◽

Comparative Clinical Study ◽

Acute Myeloid

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The Expression Changes of CX3CL1 and Interlukin-6 Genes During Remission Induction Therapy in Patients With Acute Myeloid Leukemia

Galen Medical Journal ◽

10.31661/gmj.v10i0.2288 ◽

2021 ◽

Vol 10 ◽

pp. e2288

Author(s):

Mahdiyar Iravani Saadi ◽

Mani Ramzi ◽

Aliasghar Karimi ◽

Maryam Owjfard ◽

Mahmoud Torkamani ◽

...

Keyword(s):

Acute Myeloid Leukemia ◽

Induction Chemotherapy ◽

Induction Therapy ◽

Myeloid Leukemia ◽

Hematologic Malignancy ◽

Quantitative Polymerase Chain Reaction ◽

Remission Induction ◽

Response To Chemotherapy ◽

Before And After ◽

Acute Myeloid

Background: Acute Myeloid Leukemia syndrome (AML) is a hematologic malignancy which is due to clonal extensive proliferation of leukemic precursor cells and is rapidly fatal unless treated or response to chemotherapy. Cytogenetic findings have important role in prognosis and categorization of AML. The aim of this study was to investigate the expression changes in CX3CL1 and Interlukin-6 (IL-6) genes before and after chemotherapy as remission induction therapy in AML patients. Materials and Methods: In this study 69 patients (36 males, 33 female) with AML was selected from tertiary medical heath center. A quantitative polymerase chain reaction (PCR) was done for mRNA expression of CX3CL1 and IL-6genes before and after induction chemotherapy. To obtain expression changes in CX3CL1 and IL-6genes, we used 2-ΔΔCT method. Results: The expression of CX3CL1 and IL-6 was significantly increased after induction chemotherapy. Also, the ΔCt mean of CX3CL1 and IL-6 mRNA was not significant between AML subtype groups. Conclusion: In conclusion, as we showed that chemotherapy significantly increase the expression of CX3CL1 and IL-6 which can be used as a prognostic factor of AML.

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Invasive Fungal Disease in Patients with Newly Diagnosed Acute Myeloid Leukemia

Journal of Fungi ◽

10.3390/jof7090761 ◽

2021 ◽

Vol 7 (9) ◽

pp. 761

Author(s):

Anastasia I. Wasylyshyn ◽

Kathleen A. Linder ◽

Carol A. Kauffman ◽

Blair J. Richards ◽

Stephen M. Maurer ◽

...

Keyword(s):

Acute Myeloid Leukemia ◽

Induction Chemotherapy ◽

Myeloid Leukemia ◽

Proportional Hazards ◽

Invasive Fungal Disease ◽

Fungal Disease ◽

Antifungal Prophylaxis ◽

Cell Transplant ◽

Newly Diagnosed ◽

Acute Myeloid

This single-center retrospective study of invasive fungal disease (IFD) enrolled 251 adult patients undergoing induction chemotherapy for newly diagnosed acute myeloid leukemia (AML) from 2014–2019. Patients had primary AML (n = 148, 59%); antecedent myelodysplastic syndrome (n = 76, 30%), or secondary AML (n = 27, 11%). Seventy-five patients (30%) received an allogeneic hematopoietic cell transplant within the first year after induction chemotherapy. Proven/probable IFD occurred in 17 patients (7%). Twelve of the 17 (71%) were mold infections, including aspergillosis (n = 6), fusariosis (n = 3), and mucomycosis (n = 3). Eight breakthrough IFD (B-IFD), seven of which were due to molds, occurred in patients taking antifungal prophylaxis. Patients with proven/probable IFD had a significantly greater number of cumulative neutropenic days than those without an IFD, HR = 1.038 (95% CI 1.018–1.059), p = 0.0001. By cause-specific proportional hazards regression, the risk for IFD increased by 3.8% for each day of neutropenia per 100 days of follow up. Relapsed/refractory AML significantly increased the risk for IFD, HR = 7.562 (2.585–22.123), p = 0.0002, and Kaplan-Meier analysis showed significantly higher mortality at 1 year in patients who developed a proven/probable IFD, p = 0.02. IFD remains an important problem among patients with AML despite the use of antifungal prophylaxis, and development of IFD is associated with increased mortality in these patients.

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Invasive Fungal Disease, Isavuconazole Treatment Failure, and Death in Acute Myeloid Leukemia Patients

Emerging Infectious Diseases ◽

10.3201/eid2509.190598 ◽

2019 ◽

Vol 25 (9) ◽

pp. 1778-1779 ◽

Cited By ~ 5

Author(s):

Anne-Pauline Bellanger ◽

Ana Berceanu ◽

Emeline Scherer ◽

Yohan Desbrosses ◽

Etienne Daguindau ◽

...

Keyword(s):

Acute Myeloid Leukemia ◽

Treatment Failure ◽

Myeloid Leukemia ◽

Invasive Fungal Disease ◽

Fungal Disease ◽

Acute Myeloid

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Increased angiogenesis in the bone marrow of patients with acute myeloid leukemia

Blood ◽

10.1182/blood.v95.8.2637.008k07_2637_2644 ◽

2000 ◽

Vol 95 (8) ◽

pp. 2637-2644 ◽

Cited By ~ 3

Author(s):

Teresa Padró ◽

Sandra Ruiz ◽

Ralf Bieker ◽

Horst Bürger ◽

Martin Steins ◽

...

Keyword(s):

Bone Marrow ◽

Acute Myeloid Leukemia ◽

Complete Remission ◽

Induction Chemotherapy ◽

Microvessel Density ◽

Myeloid Leukemia ◽

Remission Induction ◽

Bone Marrow Biopsies ◽

Acute Myeloid

The importance of angiogenesis for the progressive growth and viability of solid tumors is well established. In contrast, only few data are available for hematologic neoplasms. To investigate the role of angiogenesis in acute myeloid leukemia (AML), bone marrow biopsies from 62 adults with newly diagnosed, untreated AML (day 0) were evaluated. Further studies were done after the completion of remission induction chemotherapy (day 16 of induction chemotherapy, n = 21; complete remission, n = 20). Microvessels were scored in at least 3 areas (×500 field, 0.126 mm2) of the highest microvessel density in representative sections of each bone marrow specimen using immunohistochemistry for von Willebrand factor and thrombomodulin. Microvessel counts were significantly higher in patients with AML (n = 62) compared with control patients (n = 22): median (interquartile range) 24.0 (21.0-27.8)/×500 field vs 11.2 (10.0-12.0)/×500 field, respectively (P < .001). On day 16 of induction chemotherapy, microvessel density was reduced by 60% (44-66) (P < .001) in hypoplastic marrows without residual blasts, in contrast to only 17% (0-37) reduction in hypoplastic marrows with ≥ 5% residual blasts (P < .001 for the difference between both groups). Bone marrow biopsies taken at the time of complete remission displayed a microvessel density in the same range as the controls. In conclusion, there is evidence of increased microvessel density in the bone marrow of patients with AML, which supports the hypothesis of an important role of angiogenesis in AML. Furthermore, these findings suggest that antiangiogenic therapy might constitute a novel strategy for the treatment of AML.

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