Incidence and predisposing factors of infection in patients treated with hypomethylating agents

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dc.authoridKirkizlar, Onur/0000-0001-7523-8599
dc.authoridAlp Kirkizlar, Tugcan/0000-0002-1361-6213
dc.authoridDemirci, Ufuk/0000-0001-6923-1470
dc.authorwosidKirkizlar, Onur/W-9594-2018
dc.authorwosidAlp Kirkizlar, Tugcan/AAI-5246-2020
dc.contributor.authorKirkizlar, Tugcan Alp
dc.contributor.authorKirkizlar, Onur
dc.contributor.authorDemirci, Ufuk
dc.contributor.authorUmut, Aytug
dc.contributor.authorIflazoglu, Huseyin
dc.contributor.authorUmit, Elif Gulsum
dc.contributor.authorDemir, Ahmet Muzaffer
dc.date.accessioned2024-06-12T10:54:07Z
dc.date.available2024-06-12T10:54:07Z
dc.date.issued2023
dc.departmentTrakya Üniversitesien_US
dc.description.abstractObjective: Hypomethylating agents may have adverse effects such as cytopenias, cytopenia associated infections and fatality due to infections despite their favorable effects in the treatment of acute myeloid leukemia (AML), myelodysplastic syndromes (MDS) and chronic myelomonocytic leukemia (CMML). The infection prophylaxis approach is based on expert opinions and real-life experiences. Hence, we aimed to reveal the frequence of infections, predisposing factors of infection and to analyse infection attributable mortality in patients with high -risk MDS, CMML and AML who received hypomethylating agents in our center where routine infection pro-phylaxis is not applied. Material-method: 43 adult patients with AML or high-risk MDS or CMML who received HMA >= 2 consecutive cycles from January 2014 to December 2020 were enrolled in the study. Results: 43 patients and 173 treatment cycles were analyzed. The median age was 72 years and 61.3 % of patients were males. The distribution of the patients' diagnoses was; AML in 15 patients (34.9 %), high risk MDS in 20 patients (46.5 %), AML with myelodysplasia-related changes in 5 patients (11.6 %) and CMML in 3 patients (7 %). 38 infection events (21.9 %) occurred in 173 treatment cycles. 86.9 % (33 cycles) and 2.6 % (1 cycle) of infected cycles were bacterial and viral infections, respectively and 10.5 % (4 cycles) were bacterial and fungal concurrently. The most common origin of the infection was respiratory system. Hemoglobin count was lower and CRP level was higher at the beginning of the infected cycles significantly (p values were 0.002 and 0.012, respectively). Requirement of red blood cell and platelet transfusions were found to be significantly increased in the infected cycles (p values were 0.000 and 0.001, respectively). While > 4 cycles of treatment and increased platelet count were found to be protective against infection, > 6 points of Charlson Comorbidity Index (CCI) were found to increase the risk of infection. The median survival was 7.8 months in non-infected cycles while 6.83 months in infected cycles. This difference was not statistically significant (p value was 0.077). Discussion: The prevention and management of infections and infection-related deaths in patients treated with HMAs is crucial. Therefore, patients with a lower platelet count or a CCI score of > 6 may be candidates for infection prophylaxis when exposed to HMAs.en_US
dc.identifier.doi10.1016/j.leukres.2023.107043
dc.identifier.issn0145-2126
dc.identifier.issn1873-5835
dc.identifier.pmid36801588en_US
dc.identifier.scopus2-s2.0-85150351739en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.urihttps://doi.org/10.1016/j.leukres.2023.107043
dc.identifier.urihttps://hdl.handle.net/20.500.14551/18932
dc.identifier.volume127en_US
dc.identifier.wosWOS:000943372700001en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherPergamon-Elsevier Science Ltden_US
dc.relation.ispartofLeukemia Researchen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAzacitidineen_US
dc.subjectDecitabineen_US
dc.subjectInfectionen_US
dc.subjectProphylaxisen_US
dc.subjectAcute Myeloid-Leukemiaen_US
dc.subjectClinical-Practice Guidelineen_US
dc.subjectMyelodysplastic Syndromesen_US
dc.subjectDiseases Societyen_US
dc.subjectScoring Systemen_US
dc.subjectRisk-Factorsen_US
dc.subjectAzacitidineen_US
dc.subjectComplicationsen_US
dc.subjectDecitabineen_US
dc.subjectManagementen_US
dc.titleIncidence and predisposing factors of infection in patients treated with hypomethylating agentsen_US
dc.typeArticleen_US

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