title: Successful allogeneic transplantation of patients with suspected prior invasive mold infection.
abstract: Prior invasive fungal infection (IFI) has historically limited the use of allogeneic stem cell transplantation for patients with hematologic malignancies. Transplantation of such patients frequently resulted in recurrent infection and high mortality rates. Several new antifungal agents have been introduced over the past 5 years with broader spectra of activity against molds such as Aspergillus and a favorable toxicity profile. In this study, we present a series of 16 consecutive patients with hematologic malignancy and prior invasive fungal infection who underwent allogeneic transplantation. Of these patients, the majority of whom were treated with voriconazole and/or caspofungin, only four experienced recurrent fungal infection and recurrent fungal infection was the primary cause of death in only one patient. The estimated 45% 2-year survival in this series is similar to that for other patients with high risk hematologic malignancy undergoing stem cell transplantation. We conclude that suspected prior invasive fungal infection should not preclude the use of allogeneic stem cell transplantation.
authors.affiliation: Department of Internal Medicine, Cancer Research Center, University of Chicago, IL, USA.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Hill
authors.forename: Lavayna
authors.initials: L
authors.lastname: Kondapalli
authors.forename: Andrew
authors.initials: A
authors.lastname: Artz
authors.forename: Sonali
authors.initials: S
authors.lastname: Smith
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rich
authors.forename: Lucy
authors.initials: L
authors.lastname: Godley
authors.forename: Olatoyosi
authors.initials: O
authors.lastname: Odenike
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Pursell
authors.forename: Richard A
authors.initials: RA
authors.lastname: Larson
authors.forename: Wendy
authors.initials: W
authors.lastname: Stock
authors.forename: Koen
authors.initials: K
authors.lastname: van Besien
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D014184:Transplantation, Homologous