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Epidemiology and treatment of invasive fungal diseases in patients with multiple myeloma: findings from a multicenter prospective study from China

  • Original Article
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Tumor Biology

Abstract

The aim of this study is to investigate the epidemiology, diagnosis, treatment and risk factors of multiple myeloma patients with invasive fungi disease (IFD) in China. We analyzed multiple myeloma (MM) patients receiving chemotherapy in a prospective multicenter study. Basic characteristics, the diagnosis, and treatment of IFD were recorded. A total of 395 MM patients were enrolled, who received a total of 443 chemotherapy courses. Among them, 17 IFDs were diagnosed during one chemotherapy course. Fourteen of these were possible IFD and 3 were probable IFD. Ten of the 14 patients with possible IFD had lung infection. Thirty eight (8.6 %) patients received antifungal prophylaxis, and 47.4 % of them were administered with fluconazole. Patients who had a history of IFD or underwent a combined therapy with two antibiotics for over 7 days and with a history of granulocytopenia or ductus venosus insertion were more likely to be treated with antifungal prophylaxis. All of first-line antifungal therapies were monotherapy. Eleven (84.6 %) cases were treated with azoles. The median time of initial antifungal therapy was 8 days. The general condition of two patients with probable IFD and 10 patients (90.9 %) with possible IFD improved, while 1 patient with possible IFD died. Multivariate analysis revealed that history of IFD is an independent risk factor of IFD. The present multicenter study suggests that the incidence of IFD per chemotherapy courses in MM patients is 3.8 % and most patients are labelled as having possible IFD. Fluconazole is the most common antifungal agent for prophylaxis and voriconazole for therapeutic treatment. Previous IFD is a probable independent risk factor of IFD in MM patients receiving chemotherapy.

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Acknowledgments

This work was supported by Merck Sharp & Dohme China.

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Authors and Affiliations

  1. Department of Hematology, The First Affiliated Hospital, SunYat-sen University, No. 58, Zhongshan Er Road, Guangzhou, 510080, China

    Junru Liu & Juan Li

  2. The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China

    He Huang

  3. The First Affiliated Hospital of China Medical University, Shenyang, China

    Yan Li

  4. The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Lin Liu

  5. Jiangsu Province Hospital, Nanjing, China

    Jianyong Li

  6. The Second Affiliated Hospital of China Medical University, Shengjing Hospital, Shenyang, China

    Zhuogang Liu

  7. Peking University Institute of Hematology, Peking University People’s Hospital, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, No. 11 Xizhimen South Street, Beijing, China

    Jin Lu & Xiaojun Huang

  8. Nanjing Drum Tower Hospital, Nanjing, China

    Jian Ouyang

  9. Henan Tumour Hospital affiliated to Zhengzhou University, Zhengzhou, China

    Yongping Song

  10. Peking Union Medical College Hospital, Beijing, China

    Daobin Zhou

  11. The First Hospital of Peking University, Beijing, China

    Hanyun Ren

  12. Harbin Institute of Hematology and Oncology, Harbin, China

    Jun Ma

  13. The First People’s Hospital of Shanghai, Shanghai, China

    Chun Wang

  14. Chinese PLA General Hospital (301 Hospital), Beijing, China

    Li Yu

  15. The First Hospital of Harbin Medical University, Harbin, China

    Jin Zhou

  16. Changhai Hospital of the Second Military Medical University, Shanghai, China

    Jianmin Wang

  17. The General Hospital of Guangzhou Military Command of PLA, Guangzhou, China

    Yang Xiao

Authors
  1. Junru Liu
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  2. He Huang
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  3. Yan Li
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  4. Lin Liu
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  5. Jianyong Li
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  6. Zhuogang Liu
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  7. Jin Lu
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  8. Jian Ouyang
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  9. Yongping Song
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  10. Daobin Zhou
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  11. Hanyun Ren
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  12. Jun Ma
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  13. Chun Wang
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  14. Li Yu
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  15. Jin Zhou
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  16. Jianmin Wang
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  17. Yang Xiao
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  18. Xiaojun Huang
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  19. Juan Li
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Corresponding authors

Correspondence to Xiaojun Huang or Juan Li.

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The study protocol and informed consent documents were reviewed and approved by the Ethics Committee of People’s Hospital of Peking University.

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We declare that we have no conflict of interest.

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Liu, J., Huang, H., Li, Y. et al. Epidemiology and treatment of invasive fungal diseases in patients with multiple myeloma: findings from a multicenter prospective study from China. Tumor Biol. 37, 7893–7900 (2016). https://doi.org/10.1007/s13277-015-4441-8

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  • DOI: https://doi.org/10.1007/s13277-015-4441-8

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