Cause of Death/Toxicity
Out of the overall 75 deaths, most patients died either during induction (29 (38.7 %)) or consolidation (27 (36 %)). Thirteen patients (17.3 %) died during maintenance and 6 patients (8 %) died after the end of the treatment.
The cause of death during induction and consolidation was in all 56 patients due to treatment related toxicity, mostly due to infections and bleeding. During induction, 17 patients (15.5 %) died of infection, 11 (10 %) of bleeding and 1 (0.9 %) of a combination of the two. During consolidation, 18 patients (16.4 %) died of infection, 3 (2.7 %) of bleeding and 6 (5.5 %) died of a combination of infection and bleeding. During maintenance and after the end of treatment, a total of 5 patients (4.5 %) died of infection, 1 (0.9 %) of bleeding and 13 (11.8 %) due to relapse.
Relapse could not be treated given the limitations in this context. Treatment was stopped in 2 (1.8 %) patients after the diagnosis of a relapse while on therapy.
Information about bleeding and infection events is provided in table 5. Bleeding occurred mostly in the central nervous system (7) and the gastrointestinal tract (15). The main type of infection was mostly pneumonia (17), or unknown but was clinically evaluated as a severe systemic infection (13). In 22 out of 47 infections (46.8 %) a pathogen could be isolated. The isolated pathogens were mostly Escherichia coli (15) or Klebsiella pneumoniae (6). Two cases of a Cryptococcus neoformans infection were registered, as well as one case of Pseudomonas aeruginosa, and one of Pneumocystis jirovecii.