Incidence of invasive aspergillosis after allogeneic hematopoietic stem cell transplantation with a reduced-intensity regimen compared with transplantation with a conventional regimen.
To evaluate the clinical characteristics of invasive aspergillosis (IA) after reduced-intensity stem cell transplantation (RIST) compared with those after conventional stem cell transplantation (CST), we examined the medical records of 486 CST and 178 RIST recipients. The overall incidence of IA after allogeneic transplantation was 35 (5.3%) of 664, which gave a 3-year cumulative incidence of 5.6%. The estimated 3-year incidence of IA in CST and RIST was 4.5% and 8.2% (P = .045), respectively, but the mortality rates were similar (76% and 86%). The median onset of IA after RIST (day 127) occurred significantly later than that after CST (day 97). A multivariate analysis revealed that IA was associated with age older than 50 years (relative risk, 2.12; 95% confidence interval, 1.08-4.17; P = .03) and the presence of acute and/or chronic GVHD (relative risk, 6.2; 95% confidence interval, 2.4-16.4; P = .0002). IA remains an important complication after allogeneic transplantation, regardless of the type of conditioning regimen.
Hematopoietic Stem Cell Transplantation Unit, National Cancer Center Hospital, Tokyo, Japan.
Rie
R
Kojima
Masahiro
M
Kami
Yasuhito
Y
Nannya
Eiji
E
Kusumi
Miwa
M
Sakai
Yuji
Y
Tanaka
Yoshinobu
Y
Kanda
Shin-Ichiro
S
Mori
Shigeru
S
Chiba
Shigesaburo
S
Miyakoshi
Kinuko
K
Tajima
Hisamaru
H
Hirai
Shuichi
S
Taniguchi
Hisashi
H
Sakamaki
Yoichi
Y
Takaue
D000293:Adolescent; D000328:Adult; D000368:Aged; D001228:Aspergillosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015994:Incidence; D007223:Infant; D007564:Japan; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies
D007166:Immunosuppressive Agents