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Incidence and Risk Factors for Invasive Fungal Infection in Patients with Hematological Malignancies at a Tertiary Hospital in Malaysia

Summary

This study examined fungal infections in cancer patients with blood disorders in a Malaysian hospital. Researchers found that about 7.6% of patients developed serious fungal infections, mainly from Candida species. Using antifungal medications to prevent infection significantly reduced the risk, though some patients still developed infections while taking preventive medications. The findings highlight the importance of appropriate antifungal treatment strategies in managing these vulnerable patients.

Background

Invasive fungal infections (IFI) are significant causes of mortality in patients with hematological malignancies (HM), particularly those with acute leukemia and those undergoing hematopoietic stem cell transplantation (HSCT). The epidemiology of IFI varies geographically, with limited data available from Southeast Asian countries including Malaysia.

Objective

This study aims to describe the incidence and risk factors of invasive fungal infection among patients with haematological malignancies in a tertiary hospital in Malaysia. The goal is to provide local epidemiological data to guide antifungal stewardship and improve patient outcomes.

Results

IFI incidence was 7.6% with 9 proven, 1 probable, and 7 possible cases. Candida tropicalis (29.4%) and Candida krusei (17.6%) were the most common fungi isolated. AML diagnosis and concomitant bacteremia were associated with higher IFI risk, while antifungal prophylaxis significantly reduced risk (OR 0.54, p=0.019). Mortality rate from IFI was 17.6%.

Conclusion

IFI remains a serious complication in HM patients undergoing chemotherapy and HSCT, predominantly caused by non-albicans Candida species. Appropriate antifungal prophylaxis is crucial for preventing breakthrough IFI, though the study highlights challenges in diagnosis and management in resource-limited settings.
  • Published in:Asian Pacific Journal of Cancer Prevention,
  • Study Type:Cross-sectional Study,
  • Source: PMID: 40156400, DOI: 10.31557/APJCP.2025.26.3.839
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