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?:abstract
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BACKGROUND Invasive fungal disease (IFD) is frequent in patients with hematologic malignancies and in recipients of hematopoietic cell transplantation (HCT). An epidemiologic study conducted in Brazil reported a high incidence of IFD in hematologic patients, and invasive fusariosis was the leading IFD. A limitation of that study was that galactomannan was not available for at least half of the study period. OBJECTIVES Characterize the epidemiology and burden of IFD in three cohorts: HCT, acute myeloid leukemia (AML) or myelodysplasia (MDS), and acute lymphoid leukemia (ALL). METHODS This is a prospective multicenter cohort study conducted in four hematologic Brazilian centers. From August 2015 to July 2016, all patients receiving induction chemotherapy for newly diagnosed or relapsed AML, MDS or ALL, and all HCT recipients receiving conditioning regimen were followed during the period of neutropenia following chemotherapy or the conditioning regimen. RESULTS During a 1-year period, 192 patients were enrolled: 122 HCT recipients (71 allogeneic, 51 autologous), 46 with AML, and 24 with ALL. The global incidence of IFD was 13.0% (25 cases, 11 proven and 14 probable). Invasive aspergillosis (14 cases) was the leading IFD, followed by candidemia (6 cases) and fusariosis (3 cases). The incidence of IFD was 26.1% in AML/MDS, 16.7% in ALL, 11.3% in allogeneic HCT, and 2.0% in autologous HCT. CONCLUSIONS The burden of IFD in hematologic patients in Brazil is high, with a higher frequency in AML and ALL. Invasive aspergillosis is the leading IFD, followed by invasive candidiasis and fusariosis.
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