{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T18:19:03Z","timestamp":1788373143401,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T00:00:00Z","timestamp":1631664000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Veterans Education and Research Association of Michigan","award":["no number"],"award-info":[{"award-number":["no number"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>This single-center retrospective study of invasive fungal disease (IFD) enrolled 251 adult patients undergoing induction chemotherapy for newly diagnosed acute myeloid leukemia (AML) from 2014\u20132019. Patients had primary AML (n = 148, 59%); antecedent myelodysplastic syndrome (n = 76, 30%), or secondary AML (n = 27, 11%). Seventy-five patients (30%) received an allogeneic hematopoietic cell transplant within the first year after induction chemotherapy. Proven\/probable IFD occurred in 17 patients (7%). Twelve of the 17 (71%) were mold infections, including aspergillosis (n = 6), fusariosis (n = 3), and mucomycosis (n = 3). Eight breakthrough IFD (B-IFD), seven of which were due to molds, occurred in patients taking antifungal prophylaxis. Patients with proven\/probable IFD had a significantly greater number of cumulative neutropenic days than those without an IFD, HR = 1.038 (95% CI 1.018\u20131.059), p = 0.0001. By cause-specific proportional hazards regression, the risk for IFD increased by 3.8% for each day of neutropenia per 100 days of follow up. Relapsed\/refractory AML significantly increased the risk for IFD, HR = 7.562 (2.585\u201322.123), p = 0.0002, and Kaplan-Meier analysis showed significantly higher mortality at 1 year in patients who developed a proven\/probable IFD, p = 0.02. IFD remains an important problem among patients with AML despite the use of antifungal prophylaxis, and development of IFD is associated with increased mortality in these patients.<\/jats:p>","DOI":"10.3390\/jof7090761","type":"journal-article","created":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T12:00:44Z","timestamp":1631707244000},"page":"761","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Invasive Fungal Disease in Patients with Newly Diagnosed Acute Myeloid Leukemia"],"prefix":"10.3390","volume":"7","author":[{"given":"Anastasia I.","family":"Wasylyshyn","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, University of Michigan Health System, Ann Arbor, MI 48109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5352-4738","authenticated-orcid":false,"given":"Kathleen A.","family":"Linder","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Michigan Health System, Ann Arbor, MI 48109, USA"},{"name":"Infectious Diseases Section, VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol A.","family":"Kauffman","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Michigan Health System, Ann Arbor, MI 48109, USA"},{"name":"Infectious Diseases Section, VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blair J.","family":"Richards","sequence":"additional","affiliation":[{"name":"Michigan Institute for Clinical & Health Research, Ann Arbor, MI 48105, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen M.","family":"Maurer","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Michigan Health System, Ann Arbor, MI 48109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia M.","family":"Sheffield","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Michigan Health System, Ann Arbor, MI 48109, USA"},{"name":"Infectious Diseases Section, VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6828-8053","authenticated-orcid":false,"given":"Lydia","family":"Benitez Colon","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Michigan Health System, Ann Arbor, MI 48109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa H.","family":"Miceli","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Michigan Health System, Ann Arbor, MI 48109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1177\/2040620711410098","article-title":"Invasive fungal infections in acute leukemia","volume":"2","author":"Bhatt","year":"2011","journal-title":"Ther. 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