High dose cytosine arabinoside is a major risk factor for the development of hepatosplenic candidiasis in patients with leukemia.

A retrospective study of hepatosplenic candidiasis in patients with acute leukemia from a single centre was performed. The significance of age, sex, type of leukemia, dose of cytosine arabinoside (Ara-C), duration of neutropenia, steroid use and period of therapeutic antibiotics in the development of hepatosplenic candidiasis was analyzed, using logistic regression analysis. Nine of 51 patients had hepatosplenic candidiasis. Ara-C use was highly associated with the development of hepatosplenic candidiasis (p = 0.001); with a high association with a higher dose (p < 0.0001). On the basis of these results consideration should be given to further trial of antifungal prophylaxis for patients receiving high dose Ara-C.