Effect of invasive aspergillosis on risk for different causes of death in older patients with acute myeloid leukaemia or high-risk myelodysplastic syndrome
Abstract Purpose Study objectives were to estimate the cumulative incidence of death due to different causes of death (CODs) and investigate the effect of invasive aspergillosis (IA) on each separate COD in a cohort of older patients with acute myeloid leukaemia (AML) or high-risk myelodysplastic sy...
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-023-08013-5 |
| _version_ | 1811166057651503104 |
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| author | Rebecca van Grootveld Valentina Masarotto Peter A. von dem Borne Nicole M. A. Blijlevens Dana A. Chitu Martha T. van der Beek Marta Fiocco Mark G. J. de Boer |
| author_facet | Rebecca van Grootveld Valentina Masarotto Peter A. von dem Borne Nicole M. A. Blijlevens Dana A. Chitu Martha T. van der Beek Marta Fiocco Mark G. J. de Boer |
| author_sort | Rebecca van Grootveld |
| collection | DOAJ |
| description | Abstract Purpose Study objectives were to estimate the cumulative incidence of death due to different causes of death (CODs) and investigate the effect of invasive aspergillosis (IA) on each separate COD in a cohort of older patients with acute myeloid leukaemia (AML) or high-risk myelodysplastic syndrome (MDS) included in the Haemato-Oncology Foundation for Adults in the Netherlands (HOVON) 43 randomized controlled trial. Methods Pre-collected data from the trial was obtained from the HOVON data center and relevant clinical information was extracted. The cumulative incidence of death due to different CODs was estimated with a competing risk model and the association between each COD and prognostic factors, including IA, were investigated with a cause-specific hazard Cox regression model. Results In total 806 patients were included, mean age of 70 years and 55% were male. The cumulative incidences of death due to leukaemia or infection at 3, 6, 12 and 36 months were 0.06, 0.11, 0.23, 0.42 and 0.17, 0.19, 0.22, 0.25 respectively. Incidence of IA was 21% and diagnosis of IA up until the final chemotherapy cycle was associated with an increased risk of dying from leukaemia (cause-specific hazard ratio (CSHR): 1.75, 95% CI 1.34–2.28) and a trend was seen for infection (CSHR: 1.36, 95% CI 0.96–1.91). Conclusion Leukaemia was the most likely cause of death over time, however in the first year after diagnosis of AML or high-risk MDS infection was the most likely cause of death. Patients with IA had a relatively increased risk of dying from leukaemia or infection. |
| first_indexed | 2024-04-10T15:46:18Z |
| format | Article |
| id | doaj.art-519d33cf622c40b4ab878f981e53f901 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-10T15:46:18Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-519d33cf622c40b4ab878f981e53f9012023-02-12T12:05:40ZengBMCBMC Infectious Diseases1471-23342023-02-012311910.1186/s12879-023-08013-5Effect of invasive aspergillosis on risk for different causes of death in older patients with acute myeloid leukaemia or high-risk myelodysplastic syndromeRebecca van Grootveld0Valentina Masarotto1Peter A. von dem Borne2Nicole M. A. Blijlevens3Dana A. Chitu4Martha T. van der Beek5Marta Fiocco6Mark G. J. de Boer7Department of Medical Microbiology, Leiden University Medical CenterMathematical Institute, Leiden UniversityDepartment of Haematology, Leiden University Medical CenterDepartment of Haematology, Radboud University Medical CenterDepartment of Haematology, Erasmus University Medical CenterDepartment of Medical Microbiology, Leiden University Medical CenterMathematical Institute, Leiden UniversityDepartment of Infectious Diseases, Leiden University Medical CenterAbstract Purpose Study objectives were to estimate the cumulative incidence of death due to different causes of death (CODs) and investigate the effect of invasive aspergillosis (IA) on each separate COD in a cohort of older patients with acute myeloid leukaemia (AML) or high-risk myelodysplastic syndrome (MDS) included in the Haemato-Oncology Foundation for Adults in the Netherlands (HOVON) 43 randomized controlled trial. Methods Pre-collected data from the trial was obtained from the HOVON data center and relevant clinical information was extracted. The cumulative incidence of death due to different CODs was estimated with a competing risk model and the association between each COD and prognostic factors, including IA, were investigated with a cause-specific hazard Cox regression model. Results In total 806 patients were included, mean age of 70 years and 55% were male. The cumulative incidences of death due to leukaemia or infection at 3, 6, 12 and 36 months were 0.06, 0.11, 0.23, 0.42 and 0.17, 0.19, 0.22, 0.25 respectively. Incidence of IA was 21% and diagnosis of IA up until the final chemotherapy cycle was associated with an increased risk of dying from leukaemia (cause-specific hazard ratio (CSHR): 1.75, 95% CI 1.34–2.28) and a trend was seen for infection (CSHR: 1.36, 95% CI 0.96–1.91). Conclusion Leukaemia was the most likely cause of death over time, however in the first year after diagnosis of AML or high-risk MDS infection was the most likely cause of death. Patients with IA had a relatively increased risk of dying from leukaemia or infection.https://doi.org/10.1186/s12879-023-08013-5AspergillosisInvasive pulmonary aspergillosisInvasive fungal infectionAcute myeloid leukaemiaMyelodysplastic syndromesAged |
| spellingShingle | Rebecca van Grootveld Valentina Masarotto Peter A. von dem Borne Nicole M. A. Blijlevens Dana A. Chitu Martha T. van der Beek Marta Fiocco Mark G. J. de Boer Effect of invasive aspergillosis on risk for different causes of death in older patients with acute myeloid leukaemia or high-risk myelodysplastic syndrome BMC Infectious Diseases Aspergillosis Invasive pulmonary aspergillosis Invasive fungal infection Acute myeloid leukaemia Myelodysplastic syndromes Aged |
| title | Effect of invasive aspergillosis on risk for different causes of death in older patients with acute myeloid leukaemia or high-risk myelodysplastic syndrome |
| title_full | Effect of invasive aspergillosis on risk for different causes of death in older patients with acute myeloid leukaemia or high-risk myelodysplastic syndrome |
| title_fullStr | Effect of invasive aspergillosis on risk for different causes of death in older patients with acute myeloid leukaemia or high-risk myelodysplastic syndrome |
| title_full_unstemmed | Effect of invasive aspergillosis on risk for different causes of death in older patients with acute myeloid leukaemia or high-risk myelodysplastic syndrome |
| title_short | Effect of invasive aspergillosis on risk for different causes of death in older patients with acute myeloid leukaemia or high-risk myelodysplastic syndrome |
| title_sort | effect of invasive aspergillosis on risk for different causes of death in older patients with acute myeloid leukaemia or high risk myelodysplastic syndrome |
| topic | Aspergillosis Invasive pulmonary aspergillosis Invasive fungal infection Acute myeloid leukaemia Myelodysplastic syndromes Aged |
| url | https://doi.org/10.1186/s12879-023-08013-5 |
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