[Invasive fungal infections after allogeneic hematopoietic stem cell transplantation and related risk factors].
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.
Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China.
Zhi-Yong
ZY
Wang
Er-Lie
EL
Jiang
Ping
P
Zhang
Hua
H
Wang
Yu-Shi
YS
Bao
Mei
M
Wang
Si-Zhou
SZ
Feng
Ming-Zhe
MZ
Han
D000293:Adolescent; D000328:Adult; D001228:Aspergillosis / Q000453:epidemiology / Q000209:etiology*; D002177:Candidiasis / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult