Invasive fungal infections after allogeneic hematopoietic stem cell transplantation and related risk factors.
- Author:
Zhi-Yong WANG
1
;
Er-Lie JIANG
;
Ping ZHANG
;
Hua WANG
;
Yu-Shi BAO
;
Mei WANG
;
Si-Zhou FENG
;
Ming-Zhe HAN
Author Information
1. Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Aspergillosis;
epidemiology;
etiology;
Candidiasis;
epidemiology;
etiology;
Child;
Child, Preschool;
China;
epidemiology;
Female;
Graft vs Host Disease;
complications;
Hematologic Neoplasms;
therapy;
Hematopoietic Stem Cell Transplantation;
adverse effects;
Humans;
Incidence;
Male;
Middle Aged;
Risk Factors;
Young Adult
- From:
Journal of Experimental Hematology
2008;16(3):618-622
- CountryChina
- Language:Chinese
-
Abstract:
In order to analyze the incidence and high-risk factors of invasive fungal infections among recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT), 180 cases of allo-HSCT were enrolled in this study. The incidence and risk factors of IFI were analyzed by method of Kaplan-Meier and Cox regression model. The results showed that an incidence of IFI in 35 cases (19.5%) were detected, with 1 case proven and 34 cases probably diagnosed, which was composed of 18 cases (51.4%) of aspergillosis and 17 cases (48.6%) of candidosis. There was significant difference in one-year overall survival rate between patients with (34.3%) or without (53.8%) IFI. In univariate analysis, risk factors of IFI included: pretransplant fungal infection or colonization, unrelated donor (peripheral blood or bone marrow stem cell) transplantation, acute GVHD, extensive chronic GVHD and the use of methylprednisolone. In multi-variate analysis, the following risk factors of IFI were found:unrelated donor for allogeneic peripheral blood or bone marrow stem cell transplantation, acute GVHD and pretransplant fungal infection or colonization acute GVHD (RR: 2.399, 1.589, and 0.836). It is concluded that IFI is a frequent complication and one of the leading causes of mortality among recipients of allo-HSCT. As for patients with higher risk of IFI, early interventions should be taken.
