Characteristics of Patients With Hematologic Cancer and Invasive or Disseminated Fusarial Infection: Comparison Between the M.D. Anderson Cancer Center Experience and the Published Literature
| Characteristic . | M.D. Anderson . | Literature . | ||
|---|---|---|---|---|
| . | No. . | % . | No. . | % . |
| Patients | 43 | 54 | ||
| Age (yr) | ||||
| Median | 43 | |||
| 31 | ||||
| Range | 14-78 | |||
| 2-71 | ||||
| Sex (male/female) | 24/19 | |||
| 35/19 | ||||
| Underlying disease | ||||
| Acute nonlymphocytic leukemia | 23 | 53 | 26 | 48 |
| Acute lymphocytic leukemia | 7 | 16 | 20 | 37 |
| Lymphoproliferative disorders | 13 | 31 | 8 | 15 |
| Neutropenia at diagnosis | ||||
| ANC < 1,000/μL | 36 | 84 | 54 | 100 |
| ANC < 100/μL | 28 | 65 | 22 | 41* |
| BMT | 12 | 28 | 16 | 30 |
| Autologous | 3 | 25 | 6 | 33 |
| Allogeneic | 9 | 75 | 12 | 67 |
| Culture-documented sites of involvement | ||||
| Skin | 39 | 91ρ | 39 | 72 |
| Bloodstream | 18 | 42 | 30 | 56 |
| Eye | 3 | 7 | 4 | 7 |
| Bone | 3 | 7 | 3 | 6 |
| Radiologic evidence in lung† | 36 | 84 | 16 | 70 |
| Nonspecific infiltrates | 29 | 81 | 12 | 52 |
| Nodular lesions | 5 | 14 | 3 | 13 |
| Cavitary lesions | 2 | 5 | 1 | 4 |
| Radiologic evidence of sinus involvement‡ | 24 | 71 | 11 | 79 |
| Outcome | ||||
| Resolution of infection1-155 | 13 | 30 | 26 | 48 |
| Death with disseminated infection1-154 | 30 | 70 | 28 | 52 |
| Characteristic . | M.D. Anderson . | Literature . | ||
|---|---|---|---|---|
| . | No. . | % . | No. . | % . |
| Patients | 43 | 54 | ||
| Age (yr) | ||||
| Median | 43 | |||
| 31 | ||||
| Range | 14-78 | |||
| 2-71 | ||||
| Sex (male/female) | 24/19 | |||
| 35/19 | ||||
| Underlying disease | ||||
| Acute nonlymphocytic leukemia | 23 | 53 | 26 | 48 |
| Acute lymphocytic leukemia | 7 | 16 | 20 | 37 |
| Lymphoproliferative disorders | 13 | 31 | 8 | 15 |
| Neutropenia at diagnosis | ||||
| ANC < 1,000/μL | 36 | 84 | 54 | 100 |
| ANC < 100/μL | 28 | 65 | 22 | 41* |
| BMT | 12 | 28 | 16 | 30 |
| Autologous | 3 | 25 | 6 | 33 |
| Allogeneic | 9 | 75 | 12 | 67 |
| Culture-documented sites of involvement | ||||
| Skin | 39 | 91ρ | 39 | 72 |
| Bloodstream | 18 | 42 | 30 | 56 |
| Eye | 3 | 7 | 4 | 7 |
| Bone | 3 | 7 | 3 | 6 |
| Radiologic evidence in lung† | 36 | 84 | 16 | 70 |
| Nonspecific infiltrates | 29 | 81 | 12 | 52 |
| Nodular lesions | 5 | 14 | 3 | 13 |
| Cavitary lesions | 2 | 5 | 1 | 4 |
| Radiologic evidence of sinus involvement‡ | 24 | 71 | 11 | 79 |
| Outcome | ||||
| Resolution of infection1-155 | 13 | 30 | 26 | 48 |
| Death with disseminated infection1-154 | 30 | 70 | 28 | 52 |
Abbreviations: ANC, absolute neutrophil count; BMT, bone marrow transplantation.
The exact ANC was not mentioned in 31 patients reported in the literature.
Chest x-ray findings were not discussed in 31 cases reported in the literature; in 7 cases (30%), they were normal. Radiologic evaluation was available for all of our patients: in 7 patients (16%), radiologic evaluation of the lungs was normal.
Thirty-four and 14 patients, respectively, had radiologic examination of the sinuses.
ρ Skin not involved in 4 of 43 patients; in 4 patients, description of skin lesions was not available.
Resolution of infection occurred only in patients who recovered from myelosuppression.
Autopsy documentation was obtained in 41% of our patients who died with disseminated infection and 17% of cases, respectively. Two of our patients died with disseminated infection at a subsequent recurrent episode of Fusarium infection after having cleared a first episode of disseminated fusariosis.