IMPROVED SURVIVAL FROM FUNGEMIA IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES - ANALYSIS OF RISK-FACTORS FOR DEATH AND USEFULNESS OF EARLY ANTIFUNGAL THERAPY

Fourty-three episodes of fungaemia encountered from 1978 to 1991 in 43 patients with haematological malignancies are reviewed here to analys e the risk factors for death and to evaluate the efficacy of early ant ifungal therapy. Low serum cholinesterase and elevated serum blood ure a nitrogen were significantly associated with fungaemic death, defined as death occurring within 2 weeks after documentation of fungaemia. O verall death rate from fungaemia was 62.8%. Before the introduction of early antifungal therapy in 1986, however, fungaemic mortality was 85 .7%; it was reduced to 51.7% thereafter (p = 0.01). Determination of p lasma (1 --> 3)-beta-D-glucan was helpful in detecting deep fungal inf ections and initiating antifungal therapy early.