Influence of pre-existing invasive aspergillosis on allo-HSCT outcome: a retrospective EBMT analysis by the Infectious Diseases and Acute Leukemia Working Parties.
Historically, invasive aspergillosis (IA) has been a major barrier for allogeneic hematopoietic stem cell transplantation (allo-HSCT). The influence of invasive IA on long-term survival and on transplant-related complications has not been investigated in a larger patient cohort under current conditions. Our aim was to analyze the long-term outcome of patients undergoing allo-HSCT with a history of prior IA. We used European Society for Blood and Marrow Transplantation database data of first allo-HSCTs performed between 2005 and 2010 in patients with acute leukemia. One thousand one hundred and fifty patients with data on IA before allo-HSCT were included in the analysis. The median follow-up time was 52.1 months. We found no significant impact of IA on major transplant outcome variables such as overall survival, relapse-free survival, non-relapse mortality, cumulative incidence of acute GvHD grade II-IV, chronic GvHD, pulmonary complications and leukemia relapse. However, we found a trend toward lower overall survival (P=0.078, hazard ratio (HR) (95% confidence interval (CI)): 1.16 (0.98, 1.36)) and higher non-relapse mortality (P=0.150, HR (95% CI): 1.19 (0.94, 1.50)) in allo-HSCT recipients with pre-existing IA. Our data suggest that a history of IA should not generally be a contraindication when considering the performance of allo-HSCT in patients with acute leukemia.
Department of Hematology, Oncology and Tumorimmunology, Charité University Medicine Berlin, Campus Virchow Klinikum, Allogeneic Stem Cell Transplantation Service, Berlin, Germany.
O
O
Penack
Department of Paediatric Hematology and Oncology, Policlinico GB Rossi, Verona, Italy.
G
G
Tridello
EBMT Data Office, Leiden, The Netherlands.
J
J
Hoek
Service d'Hématologie Greffe, Hopital St Louis, Paris, France.
G
G
Socié
Unité de Transplantation et de Thérapie Cellulaire, Institut Paoli Calmettes, Marseille, France.
D
D
Blaise
Department of Hematology, University Hospital, Basel, Switzerland.
J
J
Passweg
Department of Hematology, CHU Nantes, Nantes, France.
P
P
Chevallier
BMT Unit, Queen Elizabeth Hospital, Birmingham, UK.
C
C
Craddock
Hématologie Clinique et thérapie cellulaire, CHU Bordeaux, Pessac, France.
N
N
Milpied
Department of Hematology, Leiden University Hospital, Leiden, The Netherlands.
H
H
Veelken
Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium.
J
J
Maertens
Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.
P
http://orcid.org/0000-0002-8281-3245
P
Ljungman
Department of Hematology, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands.
J
J
Cornelissen
Clinique d'hématologie, Hopital A Michallon, Grenoble, France.
A
A
Thiebaut-Bertrand
Department of Onco-Hematology, Nouvel Hopital Civil, Strasbourg, France.
B
B
Lioure
Department of Hematology, Centre Hospitalier Lyon Sud, Lyon, France.
M
M
Michallet
Centro Interdipartimentale di Biostatistica e Bioinformatica, Università Tor Vergata, Rome, Italy.
S
S
Iacobelli
Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel Aviv University, Tel-Hashomer, Israel.
A
A
Nagler
Service d'Hématologie Clinique et de Thérapie Cellulaire, Hospital Saint Antoine, Paris, France.
M
M
Mohty
Department of Paediatric Hematology and Oncology, Policlinico GB Rossi, Verona, Italy.
S
S
Cesaro
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D001228:Aspergillosis / Q000150:complications / Q000401:mortality / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D007938:Leukemia / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015996:Survival Rate