People with acute myeloid leukemia (AML) have an increased risk of fungal infections, which can be extremely serious if they spread to other parts of the body. Doctors may sometimes advise people with AML to take antifungal medications.
The two main microbes that can cause an AML fungal infection are Candida and Aspergillus, both of which can spread throughout the body.
This article discusses the link between AML and fungal infections. It also considers the risk factors, preventive measures, and treatment options.
People with AML have a higher likelihood of contracting infections, including fungal ones. This increased risk stems from how AML affects immunity.
The American Cancer Society explains that leukemia cells replace healthy blood-making cells in the bone marrow. As a result, the body may produce low numbers of white blood cells.
According to the
People receiving treatment for AML have reduced numbers of white blood cells from both chemotherapy and the disease itself. Therefore, they are particularly at risk of infections, including fungal infections.
Some fungal infections that affect a person with decreased immunity are mild and only cause a rash. Others may become invasive, which means that they spread to other parts of the body. Invasive infections
Invasive fungal infections are one of the
Candida naturally lives in the
This fungus does not cause symptoms unless it grows so much that it becomes out of control.
A Candida infection
People contract an Aspergillus infection when they breathe in spores from the fungus, which is a
Symptoms of an invasive Aspergillus infection
If the fungus spreads from the lungs to other parts of the body, it can produce additional symptoms.
- taking stronger, or more aggressive, chemotherapy drugs
- staying in the hospital a long time — for example, due to undergoing a stem cell transplant
- living in a geographical area where fungi are more prevalent
As fungi are a natural part of a person’s environment, they are hard to avoid.
- learning about fungal infections, which may help them recognize the symptoms and get treatment early
- visiting a doctor regularly, which may lead to a quicker diagnosis
- taking antifungal medications when a doctor prescribes them
The CDC also suggests taking the following steps to prevent exposure to fungi in the environment:
- avoiding areas with lots of dust, such as construction sites
- wearing gloves when handling soil or manure
- staying away from places with bird and bat droppings, such as caves or chicken coops
- staying indoors during dust storms
- wearing shoes, long pants, and shirts with long sleeves when working outdoors
Doctors use medications for prevention, as well as for treatment once a fungal infection develops.
Medications for prevention
A 2019 study reported that the incidence of invasive fungal infections in people with AML ranges from 12% to 24%. For this reason, the authors recommend that individuals with AML take antifungal medications even before they receive a diagnosis of an infection.
This type of strategy, which prevents rather than treats disease, is called prophylaxis. The study authors recommend taking such medications for as long as the white blood cell count remains low.
Medication options include:
- fluconazole (Diflucan)
- itraconazole (Sporanox)
- voriconazole (Vfend)
- posaconazole (Noxafil)
- micafungin (Mycamine)
Not all doctors believe that a person with AML should take antifungal drugs for prevention. A
The authors concluded that both prevention strategies had advantages and disadvantages.
One of the disadvantages of taking preventive medication involves the possible side effects of the medications that some individuals cannot tolerate.
Medications for treatment
For an invasive Candida infection, the type and dosage of medications depend on various factors, such as a person’s age and the severity of the illness.
The initial treatment
To treat an invasive Aspergillus infection, the
The CDC also advises reducing the dosage of medications that suppress the immune system or discontinuing their use. Someone who has a severe infection may need surgery.
Two older case studies suggest that treatment may prevent the recurrence of fungal infections in people with AML.
An AML fungal infection occurs because people with cancer have low numbers of the white blood cells that enable the body to fight infections. Doctors refer to this as compromised immunity.
It is important for a person with leukemia to be aware of the signs of a fungal infection and visit their doctor regularly. A prompt diagnosis and early treatment can prevent the spread of the infection. As invasive fungal infections are very dangerous, early treatment may save lives.