title: Risk factors for invasive mold infections following allogeneic hematopoietic stem cell transplantation: a single center study of 190 recipients.
abstract: BACKGROUND
  Invasive mold infection (IMI) is a major cause of infection-related mortality following allogeneic hematopoietic stem cell transplantation (allo-HSCT).
  
  
  METHODS
  We retrospectively analyzed 190 allo-HSCT recipients at Changhai Hospital between the y 2000 and 2007. The survival rate was evaluated with Kaplan-Meier curves. Logistic and Cox regression models were used for multivariate analyses.
  
  
  RESULTS
  The 1(st) y cumulative incidence rate of IMI was 12.8%, and invasive aspergillosis was the most commonly observed IMI (85%). Multivariate logistic regression analyses showed that significant predictors of IMI were corticosteroid therapy (odds ratio (OR) 1.656, 95% confidence interval (CI) 1.047-2.621, p = 0.031), positive cytomegalovirus antigenemia (OR 5.301, 95% CI 1.902-14.772, p = 0.001), and secondary neutropenia (OR 5.250, 95% CI 1.741-15.834, p = 0.003). The mortality rate of IMI at 12 weeks after diagnosis was 60%. In Cox regression models, IMI-related mortality was related to the dose of corticosteroid (2 mg/kg/day or more) administered at the time of IMI diagnosis (hazards ratio (HR) 20.841, 95% CI 2.151-201.944, p = 0.009) and neutropenia (HR 7.043, 95% CI 1.186-41.827, p = 0.032).
  
  
  CONCLUSIONS
  These data confirm previous findings that the incidence and mortality of IMI are mostly associated with immunodeficiency caused by immunosuppressive therapy or virus infection.
authors: Department of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors: Lili
authors: L
authors: Li
authors: Jianmin
authors: J
authors: Wang
authors: Weiping
authors: W
authors: Zhang
authors: Jianmin
authors: J
authors: Yang
authors: Li
authors: L
authors: Chen
authors: Shuqing
authors: S
authors: Lv
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009181:Mycoses / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D009503:Neutropenia / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000935:Antifungal Agents