Impact of vancomycin-resistant enterococcal bacteremia on outcome during acute myeloid leukemia induction therapy

Leuk Lymphoma. 2015;56(9):2536-42. doi: 10.3109/10428194.2014.1003557. Epub 2015 Feb 20.

Abstract

This study aimed to identify the rate and impact of vancomycin-resistant enterococcal (VRE) bacteremia in patients with acute myeloid leukemia (AML) receiving induction chemotherapy (IC). Thirty-seven (10.6%) of 350 patients had VRE bacteremia during IC, with increasing rates of VRE bacteremia over the course of the study period. The overall complete remission (CR) rate for the cohort was 73%, and there was no difference in CR rate between the VRE bacteremia and non-VRE bacteremia cohorts (70% vs. 73%, p = 0.70). Unadjusted median overall survival (OS) was 12.8 months, and differed significantly between those with and without VRE bacteremia (7.1 months vs. 13.1 months, respectively; p = 0.03). The presence of VRE bacteremia during IC for AML was independently associated with increased all-cause mortality (hazard ratio 1.72, 95% confidence interval 1.13-2.63, p = 0.01).

Keywords: AML; VRE; enterococcus; induction chemotherapy; leukemia; survival.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteremia / complications
  • Bacteremia / microbiology*
  • Female
  • Gram-Negative Bacterial Infections / complications
  • Gram-Negative Bacterial Infections / microbiology*
  • Host-Pathogen Interactions
  • Humans
  • Induction Chemotherapy
  • Kaplan-Meier Estimate
  • Leukemia, Myeloid / complications
  • Leukemia, Myeloid / drug therapy*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Prognosis
  • Proportional Hazards Models
  • Remission Induction
  • Vancomycin-Resistant Enterococci / physiology*
  • Young Adult