Invasive Fungal Infections in Acute Promyelocytic Leukemia on Dual Differentiating Agents: Real World Data
- 15 Downloads
Invasive fungal infection (IFI) in patients with acute promyelocytic leukemia (APL) is a common phenomenon in developing countries. In a systematic study (Dual Inducing Differentiating agents—Indian Trial: DID-IT) using dual differentiating agents (ATO and ATRA) in 98 APL patients at our center we report 18.3% incidence of IFI (n-18). Among all cases of IFI three were definitive, 14 were probable and one was possible IFI. We conclude that incidence of IFI in APL is affected by environmental and therapy related factors and mere usage of dual differentiating agents need not necessarily decrease the incidence of fungal infections.
KeywordsAPL Fungal infection ATO ATRA
All authors participated in the study, YU, PKK and PM analyzed the data and wrote the paper, SV and PM designed the research study and AC’s laboratory performed fungal studies. All authors were involved in the management of the patients. YU and PM were involved in the manuscript preparation. All authors vetted the submitted manuscript.
This study was not funded by any agency.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 2.Varma S, Yanamandra U, Khadwal A, Prakash G, Suri V, Kumari S et al (2015) High risk Apml treated successfully with four cycles of ATO and ATRA combination in resource constrained settings. Blood 126(23):3322Google Scholar
- 3.Kakkar N, Bharani V, Gupta O, Shrestha D, Das A, Varma SC (2015) Respiratory distress in acute promyelocytic leukemia after ATRA therapy: not always due to differentiation syndrome. Clinicopathological conference report—PM25443. J Postgrad Med Edu Res 49(2):94–100. doi: 10.5005/jp-journals-10028-1155 CrossRefGoogle Scholar
- 4.De Pauw B, Walsh TJ, Donnelly JP, Stevens DA, Edwards JE, Calandra T et al (2008) Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 46(12):1813–1821CrossRefPubMedPubMedCentralGoogle Scholar
- 5.Jain A, Prakash G, Singh C et al (2017) Analysis of clinical profile and outcome of tuberculosis in patients with acute leukemia. Indian J Hematol Blood Transfus. doi: 10.1007/s12288-017-0875-z