The impact of IMI on patient mortality
The overall survival of children with hematologic malignancy and IMI was
57% (35 out of 61 have survived to date, with a minimum of two years of
follow up since cancer diagnosis). For the 11 AML cases with IMI, only 3
survived (27%), and for the 45 ALL cases with IMI, 30 survived (67%).
Of the 61 IMIs diagnosed between 2006 and 2020, 14 occurred in patients
with relapsed/refractory leukemia or lymphoma, and 47 occurred in
patients who were in clinical remission. Unsurprisingly, 12/14 (86%)
relapsed/refractory patients died, vs. 14/47 (30%) patients who were in
remission at the time of their IMI diagnosis (p=0.0002). Eighteen out of
the 26 patients who died had active fungal disease at the time of their
death (69%). There was no notable difference in mortality risk pre- and
post-implementation of the TCH antifungal algorithm. Of the 47 IMI cases
diagnosed from 2006-2015, 20 (43%) died and 13 (65%) had active fungal
disease at the time of their death. Out of the 14 IMI cases diagnosed
from 2016-2020: 6 (43%) died and 5 (83%) had active fungal disease at
the time of their death.