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Hepatosplenic Candidiasis in Patients With Hematological Malignancies: A 13-Year Retrospective Cohort Study
BACKGROUND: Hepatosplenic candidiasis (HSC) used to be reported in patients with acute myeloid leukemia (AML) without antifungal prophylaxis. The aim was to describe the clinical features and outcomes of HSC over the last 13 years in a single French hematology center. METHODS: All patients diagnosed...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8962726/ https://www.ncbi.nlm.nih.gov/pubmed/35355897 http://dx.doi.org/10.1093/ofid/ofac088 |
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author | Boussen, Inès Lisan, Quentin Raffoux, Emmanuel Di Blasi, Roberta Boissel, Nicolas Oksenhendler, Eric Adès, Lionel Xhaard, Aliénor Bretagne, Stéphane Alanio, Alexandre Molina, Jean-Michel Denis, Blandine |
author_facet | Boussen, Inès Lisan, Quentin Raffoux, Emmanuel Di Blasi, Roberta Boissel, Nicolas Oksenhendler, Eric Adès, Lionel Xhaard, Aliénor Bretagne, Stéphane Alanio, Alexandre Molina, Jean-Michel Denis, Blandine |
author_sort | Boussen, Inès |
collection | PubMed |
description | BACKGROUND: Hepatosplenic candidiasis (HSC) used to be reported in patients with acute myeloid leukemia (AML) without antifungal prophylaxis. The aim was to describe the clinical features and outcomes of HSC over the last 13 years in a single French hematology center. METHODS: All patients diagnosed with HSC between 2008 and 2020 were included in a single-center retrospective cohort study. Data were collected from patient charts, and HSC was classified according to the 2020 European Organisation for Research and Treatment of Cancer/Mycoses Study Group definitions. RESULTS: Sixty patients were included, with 18.3% proven, 3.3% probable, and 78.3% possible HSC according to the 2020 European Organization for Research and Treatment of Cancer Mycoses Study Group classification. Among them, 19 patients were treated for acute myeloid leukemia (AML), 21 for lymphomas, and 14 for acute lymphoblastic leukemia. HSC occurred in 13 patients after autologous stem cell transplantation for lymphoma. At HSC diagnosis, 13 patients were receiving antifungal prophylaxis. Candida colonization was present in 84.2%, with prior candidemia in 36.7% of cases. β-D-glucans was positive in 55.8%, and 45.8% of tissue biopsies were contributive. First-line antifungal therapy was azoles in 61.7%, and steroids were associated in 45% of cases. At 3 months of follow-up, partial response to antifungal therapy was 94.2%. At last follow-up (mean, 22.6 months), 41 patients (68.3%) presented a complete hematological remission and 22 patients were deceased, none because of HSC. CONCLUSIONS: The epidemiology of HSC has changed in the last decade, with fewer cases occurring in the AML setting. A better identification of patients at risk could lead to specific prophylaxis and improved diagnosis. |
format | Online Article Text |
id | pubmed-8962726 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-89627262022-03-29 Hepatosplenic Candidiasis in Patients With Hematological Malignancies: A 13-Year Retrospective Cohort Study Boussen, Inès Lisan, Quentin Raffoux, Emmanuel Di Blasi, Roberta Boissel, Nicolas Oksenhendler, Eric Adès, Lionel Xhaard, Aliénor Bretagne, Stéphane Alanio, Alexandre Molina, Jean-Michel Denis, Blandine Open Forum Infect Dis Major Article BACKGROUND: Hepatosplenic candidiasis (HSC) used to be reported in patients with acute myeloid leukemia (AML) without antifungal prophylaxis. The aim was to describe the clinical features and outcomes of HSC over the last 13 years in a single French hematology center. METHODS: All patients diagnosed with HSC between 2008 and 2020 were included in a single-center retrospective cohort study. Data were collected from patient charts, and HSC was classified according to the 2020 European Organisation for Research and Treatment of Cancer/Mycoses Study Group definitions. RESULTS: Sixty patients were included, with 18.3% proven, 3.3% probable, and 78.3% possible HSC according to the 2020 European Organization for Research and Treatment of Cancer Mycoses Study Group classification. Among them, 19 patients were treated for acute myeloid leukemia (AML), 21 for lymphomas, and 14 for acute lymphoblastic leukemia. HSC occurred in 13 patients after autologous stem cell transplantation for lymphoma. At HSC diagnosis, 13 patients were receiving antifungal prophylaxis. Candida colonization was present in 84.2%, with prior candidemia in 36.7% of cases. β-D-glucans was positive in 55.8%, and 45.8% of tissue biopsies were contributive. First-line antifungal therapy was azoles in 61.7%, and steroids were associated in 45% of cases. At 3 months of follow-up, partial response to antifungal therapy was 94.2%. At last follow-up (mean, 22.6 months), 41 patients (68.3%) presented a complete hematological remission and 22 patients were deceased, none because of HSC. CONCLUSIONS: The epidemiology of HSC has changed in the last decade, with fewer cases occurring in the AML setting. A better identification of patients at risk could lead to specific prophylaxis and improved diagnosis. Oxford University Press 2022-03-07 /pmc/articles/PMC8962726/ /pubmed/35355897 http://dx.doi.org/10.1093/ofid/ofac088 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Major Article Boussen, Inès Lisan, Quentin Raffoux, Emmanuel Di Blasi, Roberta Boissel, Nicolas Oksenhendler, Eric Adès, Lionel Xhaard, Aliénor Bretagne, Stéphane Alanio, Alexandre Molina, Jean-Michel Denis, Blandine Hepatosplenic Candidiasis in Patients With Hematological Malignancies: A 13-Year Retrospective Cohort Study |
title | Hepatosplenic Candidiasis in Patients With Hematological Malignancies: A 13-Year Retrospective Cohort Study |
title_full | Hepatosplenic Candidiasis in Patients With Hematological Malignancies: A 13-Year Retrospective Cohort Study |
title_fullStr | Hepatosplenic Candidiasis in Patients With Hematological Malignancies: A 13-Year Retrospective Cohort Study |
title_full_unstemmed | Hepatosplenic Candidiasis in Patients With Hematological Malignancies: A 13-Year Retrospective Cohort Study |
title_short | Hepatosplenic Candidiasis in Patients With Hematological Malignancies: A 13-Year Retrospective Cohort Study |
title_sort | hepatosplenic candidiasis in patients with hematological malignancies: a 13-year retrospective cohort study |
topic | Major Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8962726/ https://www.ncbi.nlm.nih.gov/pubmed/35355897 http://dx.doi.org/10.1093/ofid/ofac088 |
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