The effect of antifungal profilaxi and antifungal treatment on survival in patients with invasive fungal infection in Hematology Clinic of Dicle University Medical Faculty Hospital

ABSTRACT Introduction: Invasive fungal infection (IFI) is an important cause of morbidity and mortality in the patients with hemotologic malignancy and hematopoetic stem cell transplantation. In this study, our aim is to evaluate the response to the treatment in the patients diagnosed with IFI radiologically and treated with anti-fungal treatment, efficacy of antifungal agents and the number of the neutropenic days on survival. Material and Method: In this study, 84 patients diagnosed with IFI radiologically between January 2014-July 2020 in the Hematology Clinic of Dicle University were included. Comorbid diseases of patients, white blood cell and neutrophil counts at the time of febrile neutropenia, treatment options and responses, mean survival times, and the effect of administered antifungal treatments on survival was investigated. Results: Out of 84 patients, there were 54 (%64,3) male and 30 (%35,7) female patients. Mean age was 44,7±16,66 years. The mean time of follow-up and survival was 17,40+16,31 and 20,9±2,6 months respectively. The mean time of survival was longer in patients with BMT than those without (28,4 months and 18,7 months respectively) (P:0,042). There were 14 patients with neutropenic days less than 10 days and 70 patients with neutropenic days more than 10. The mean survival was longer in patients with less than 10 days of neutropenic days (P:0,005). The most commonly used anti-fungal treatments were voriconazole in 68 (81%) patients and liposomal amphotericin B (L-AmB) in 16 (19%) patients. Conclusion: As a result of this study, the presence of IFI, number of neutropenic days, and BMT was found to statistically significant on survival. The polyene (L-AmB) and azole (posaconazole, itraconazole, and voriconazole) groups were the most commonly used anti-fungal drugs, and Voriconazole was the most preemptive drug used in our patients. Key words: Invasive fungal infection, neutropenia, survival, hematologic malignancy