Prevalence and Clinical Risk Factors for Invasive Aspergillosis in Patients with Acute Leukemia at Srinagarind Hospital, Khon Kaen University
Sakaren Lawong1, Wantin Sribenjalux1,2,4, Atibordee Meesing1,2,4, Nattiya Teawtrakul1,3
Affiliation : 1 Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, 2 Division of Infectious diseases and Tropical Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, 3 Division of Hematology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, 4 Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen, Thailand
Objective: Invasive aspergillosis (IA) is the most common fungal infection in patients with acute leukemia and associated with high mortality rate. We aimed to report the prevalence and clinical risk factors of IA in patients with acute leukemia at Srinagarind Hospital, Khon Kaen University.
Materials and Methods: A retrospectively study was performed in adult acute leukemia patients who were diagnosed with IA from January 2006 to December 2015 at Srinagarind Hospital, Khon Kaen University. IA was defined by the European Organization for Research and Treatment of Cancer and the Mycoses Study Group. Clinical characteristics and laboratory data were analyzed. Multivariate logistic regression analysis was used to determine the associations.
Results: A total of 355 patients with acute leukemia, invasive aspergillosis was found in 39 patients (11%). The median age was 46 years (IQR of 33 to 59 years). Gender distribution was equal between males and females. Most common type of leukemias in the study are acute myeloid leukemia non-M3 (50.7%), followed by acute myeloid leukemia M3 (24.8%), and acute lymphoblastic leukemia (24.8%) respectively. Using logistic regression analysis, patients who had neutropenia at the time of IA diagnosed (adjusted OR 3.54; p=0.014), hepatitis B viral infection (adjusted OR 3.13; p=0.03), and working as construction worker (adjusted OR 23.08; p<0.001) remained the risk factor of IA.
Conclusion: The prevalence of IA in Thai patients with acute leukemia is modest. Neutropenia, hepatitis B viral infection and construction worker were significant clinical risk factors for IA in patients with acute leukemia.
doi.org/10.35755/jmedassocthai.2021.S04.00042
Keywords : Invasive aspergillosis; Acute leukemia; Srinagarind Hospital
