title: Invasive aspergillosis as an opportunistic infection in nonallografted patients with multiple myeloma: a European Organization for Research and Treatment of Cancer/ Invasive Fungal Infections Cooperative Group and the Intergroupe Français du Myélome.
abstract: We report the occurrence of invasive aspergillosis (IA) in nonallografted patients with multiple myeloma (MM) who were treated at hematology or oncology centers in Europe during 1984-1996. Thirty-one cases met the criteria for definitive (21 [68%]) or probable (10 [32%]) IA. Of these cases, 23 (74%) were reported during 1992-1996. Twenty-nine cases (94%) occurred in patients with Durie-Salmon stage 3 MM, and 2 (6%) occurred in patients with Durie-Salmon stage 2 MM. The median time between MM and IA diagnoses was 8 months (range, 1-75 months). Sixteen patients (51%) had a neutrophil count </=500/mm3 for a median duration of 19 days (range, 10-37 days). Fourteen patients (45%) had recently received corticosteroid therapy, and 11 (36%), high doses of melphalan. Twenty-eight patients had primary pulmonary IA, and 3 had primary sinus IA. Forty-five percent of patients were considered to have died of IA. IA occurs as a potentially lethal opportunistic infection in intensively treated nonallografted patients with myeloma.
authors.affiliation: Service de Médecine Interne, Centre de Recherche en Pathologie Infectieuse et Tropicale, Hôpital Avicenne, Université Paris Nord, Bobigny, France.
authors.forename: O
authors.initials: O
authors.lastname: Lortholary
authors.forename: S
authors.initials: S
authors.lastname: Ascioglu
authors.forename: P
authors.initials: P
authors.lastname: Moreau
authors.forename: R
authors.initials: R
authors.lastname: Herbrecht
authors.forename: A
authors.initials: A
authors.lastname: Marinus
authors.forename: P
authors.initials: P
authors.lastname: Casassus
authors.forename: B
authors.initials: B
authors.lastname: De Pauw
authors.forename: D W
authors.initials: DW
authors.lastname: Denning
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D005060:Europe; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000628:therapy; D009894:Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B