Pagano et al identified risk factors for invasive fungal infections (IFI) in patients with acute lymphoblastic leukemia (ALL). These can help to identify a patient who may benefit from more aggressive management. The authors are members of SEIFEM (Sorveglianza Epidemiologica Infezioni Fungine nelle Emopatie Maligne) Group in Italy.
High risk category:
(1) age >= 55 years of age
(2) intensive (pediatric-like) induction regimen
(3) high dose dexamethasone
(4) relapsed or refractory disease (previously treated)
Intermediate risk category:
(1) age 30 to 54 years of age
(2) standard induction therapy
(3) intensive consolidation therapy
(4) tyrosine kinase inhibitor (TKI) and reduced intensity chemotherapy (Philadelphia chromosome positive ALL)
Low risk category:
(1) age < 30 years of age
(2) in complete remission on maintenance therapy
(3) tyrosine kinase inhibitor (TKI) plus steroids (Philadelphia positive ALL)
