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Cancer Med ; 6(12): 2814-2821, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29058375

RESUMEN

Decitabine has been explored as a reduced-intensity therapy for older or unfit patients with acute myeloid leukemia (AML). To better understand the risk of infections during decitabine treatment, we retrospectively examined the culture results from each infection-related serious adverse event that occurred among 85 AML and myelodysplastic syndromes (MDS) patients treated in a prospective clinical study using 10-day cycles of decitabine at Washington University School of Medicine. Culture results were available for 163 infection-related complications that occurred in 70 patients: 90 (55.2%) events were culture-negative, 32 (19.6%) were gram-positive bacteria, 20 (12.3%) were gram-negative bacteria, 12 (7.4%) were mixed, 6 (3.7%) were viral, 2 (1.2%) were fungal, and 1 (0.6%) was mycobacterial. Infection-related mortality occurred in 3/24 (13%) of gram-negative events, and 0/51 gram-positive events. On average, nearly one third of patients experienced an infection-related complication with each cycle, and the incidence did not decrease during later cycles. In summary, in patients receiving 10-day decitabine, infectious complications are common and may occur during any cycle of therapy. Although febrile events are commonly culture-negative, gram-positive infections are the most frequent source of culture-positive infections, but gram-negative infections represent a significant risk of mortality in AML and MDS patients treated with decitabine.


Asunto(s)
Antimetabolitos Antineoplásicos/efectos adversos , Azacitidina/análogos & derivados , Infecciones por Bacterias Gramnegativas/inducido químicamente , Infecciones por Bacterias Grampositivas/inducido químicamente , Leucemia Mieloide Aguda/tratamiento farmacológico , Síndromes Mielodisplásicos/tratamiento farmacológico , Infecciones Oportunistas/inducido químicamente , Adulto , Anciano , Anciano de 80 o más Años , Antimetabolitos Antineoplásicos/administración & dosificación , Azacitidina/administración & dosificación , Azacitidina/efectos adversos , Decitabina , Esquema de Medicación , Femenino , Fiebre/inducido químicamente , Fiebre/mortalidad , Infecciones por Bacterias Gramnegativas/microbiología , Infecciones por Bacterias Gramnegativas/mortalidad , Infecciones por Bacterias Grampositivas/microbiología , Infecciones por Bacterias Grampositivas/mortalidad , Humanos , Incidencia , Leucemia Mieloide Aguda/diagnóstico , Masculino , Persona de Mediana Edad , Missouri , Micosis/inducido químicamente , Micosis/microbiología , Micosis/mortalidad , Síndromes Mielodisplásicos/diagnóstico , Neutropenia/inducido químicamente , Neutropenia/mortalidad , Infecciones Oportunistas/diagnóstico , Infecciones Oportunistas/microbiología , Infecciones Oportunistas/mortalidad , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Virosis/inducido químicamente , Virosis/mortalidad , Virosis/virología
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