Fusarium infection in hematopoietic stem cell transplant recipients.
To characterize the epidemiology and prognostic factors of invasive fusariosis in hematopoietic stem cell transplant (HSCT) recipients, the records of HSCT recipients from 9 hospitals (7 in Brazil and 2 in the United States) were retrospectively reviewed. Sixty-one cases were identified: 54 in allogeneic HSCT recipients and 7 in autologous HSCT recipients. The incidence of fusariosis among allogeneic HSCT recipients varied between a range of 4.21-5.0 cases per 1000 in human leukocyte antigen (HLA)--matched related transplant recipients to 20.19 cases per 1000 in HLA-mismatched transplant recipients. The median time period between transplantation and diagnosis of fusariosis was 48 days. Among allogeneic HSCT recipients, a trimodal distribution was observed: a first peak before engraftment, a second peak at a median of 62 days after transplantation, and a third peak >1 year after transplantation. The actuarial survival was 13% (median, 13 days). Persistent neutropenia was the single prognostic factor for death identified by multivariate analysis.
Nucci
Marcio
M
University Hospital, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. mnucci@hucff.ufrj.br
Marr
Kieren A
KA
Queiroz-Telles
Flavio
F
Martins
Carlos A
CA
Trabasso
Plinio
P
Costa
Silvia
S
Voltarelli
Julio C
JC
Colombo
Arnaldo L
AL
Imhof
Alexander
A
Pasquini
Ricardo
R
Maiolino
Angelo
A
Souza
Cármino A
CA
Anaissie
Elias
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005670:Fusarium; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D009894:Opportunistic Infections / Q000453:epidemiology* / Q000209:etiology; D014481:United States / Q000453:epidemiology