Invasive Mold Infections in FLT3-Mutated Acute Myeloid Leukemia |
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| Authors: | Pakpoom Phoompoung Benoît Henry Georgina Daher-Reyes Hassan Sibai Shahid Husain |
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| Affiliation: | 1. Transplant Infectious Diseases, Ajmera Transplant Centre;2. Princess Margaret Cancer Centre, University Health Network, Toronto, Canada;3. Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand;1. Department of Radiation Oncology Duke University Medical Center, Durham, NC;2. Department of Pathology, Duke University Medical Center, Durham, NC;3. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC;4. Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, NC;1. III Department of Medicine, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany;2. Center for Cardiology–Cardiology I, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany;3. Department of Dermatology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany;1. Department of Pharmacy, Boston Medical Center, Boston, MA;2. Amyloidosis Center, Boston University School of Medicine, Boston, MA;3. Albany College of Pharmacy and Health Sciences, Albany, NY;1. Department of Medical Microbiology, Karabuk University Faculty of Medicine, Karabuk, Turkey;2. Department of Medical Microbiology, Gazi University Faculty of Medicine, Ankara, Turkey;3. Department of Haematology, Gazi University Faculty of Medicine, Ankara, Turkey;4. Department of Medical Microbiology, Ahmet Yesevi International Kazakh-Turkish University Faculty of Medicine, Turkistan, Kazakhstan;1. Division of Hematology/Oncology, University of California Davis School of Medicine, UC Davis Comprehensive Cancer Center, Sacramento, CA;2. Department of Haematology, Lille University Hospital, Lille, France;3. Bristol Myers Squibb, Princeton, NJ;4. Formerly Celgene Corporation, Summit, NJ;5. Veterans Administration Northern California Health Care System, Sacramento, CA |
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| Abstract: | BackgroundThe incidence and risk factors for invasive mold infections (IMI) in acute myeloid leukemia (AML) patients carrying FLT3 mutations have not been addressed.Patients and MethodsThis retrospective cohort included FLT3-mutated AML patients (2008-2018). Primary outcome was IMI incidence within 6 months after first induction or salvage therapy.ResultsWe included 108 patients receiving fluconazole or micafungin prophylaxis. IMI incidence after induction and salvage therapy was 4.8% and 14.8%, respectively, and did not differ between patients receiving 3+7 regimen or 3+7 plus midostaurin (4.3% vs 4.5%). In a bivariate analysis, age (odds ratio, 1.11; P = .027) and FLT3 ITD mutation (odds ratio, 0.05; P = .023) were independently associated with IMI after induction chemotherapy. Gilteritinib was more frequently prescribed in patients with relapsed/refractory disease who developed IMI (50% vs 27.3%, P = .563).ConclusionFLT3 ITD mutation may be a preventive factor for IMI. Neither midostaurin nor salvage gilteritinib significantly increased the risk of IMI in this population. |
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| Keywords: | FLT3 mutation Gilteritinib Invasive aspergillosis Invasive fungal infection Midostaurin |
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