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Bainschab, A; Quehenberger, F; Greinix, HT; Krause, R; Wölfler, A; Sill, H; Zebisch, A.
Infections in patients with acute myeloid leukemia treated with low-intensity therapeutic regimens: Risk factors and efficacy of antibiotic prophylaxis.
Leuk Res. 2016; 42(3):47-51
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Autor/innen der Med Uni Graz:
Greinix Hildegard
Krause Robert
Quehenberger Franz
Sill Heinz
Wölfler Albert
Zebisch Armin
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Abstract:
Survival of acute myeloid leukemia (AML) patients, who are unfit for high-dose chemotherapy, has significantly improved with the advent of low-intensity therapeutic regimens (LITR, comprising decitabine, azacitidine, and low-dose cytarabine). However, infectious complications are common during LITR treatment and might hamper the beneficial effect of these drugs. In this study, we aimed to evaluate the incidence of and predisposing risk factors for infections during LITR treatment of AML, as well as the value of antibiotic prophylaxis within this setting. Therefore, we retrospectively analyzed 40 AML patients, treated with 215 cycles of LITR and analyzed putative risk factors by multivariate logistic regression. Infections occurred in 53/215 (25%) of LITR cycles, resulting in death in six patients. Of the parameters assessed at the start of each LITR cycle, transfusion dependence (p=0.008) and increased LDH (p=0.027) independently predicted the occurrence of infection. Most importantly, however, antibiotic prophylaxis was independently associated with a decreased rate of infectious complications (p=0.030). It was regularly performed in neutropenic patients and even managed to eliminate low neutrophil counts as risk factor in multivariate models. These data argue for the efficacy of antibiotic prophylaxis during LITR therapy of AML and suggest its further evaluation within a prospective clinical trial. Copyright © 2016 Elsevier Ltd. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Aged -
Aged, 80 and over -
Antibiotic Prophylaxis - methods
Antimetabolites, Antineoplastic - administration & dosage
Antimetabolites, Antineoplastic - adverse effects
Azacitidine - administration & dosage
Azacitidine - adverse effects
Azacitidine - analogs & derivatives
Bacterial Infections - etiology
Bacterial Infections - prevention & control
Cytarabine - administration & dosage
Cytarabine - adverse effects
Decitabine -
Female -
Humans -
Leukemia, Myeloid, Acute - drug therapy
Male -
Middle Aged -
Retrospective Studies -
Risk Factors -
Virus Diseases - etiology
Virus Diseases - prevention & control

Find related publications in this database (Keywords)
Acute myeloid leukemia
Low-intensity treatment regimen
Infection
Antibiotic prophylaxis
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