Factors associated with overall survival after allogeneic and autologous hematopoietic stem cell transplantation in patients with concomitant invasive fungal infection

Cellular Therapy and Transplantation

Julia V. Borzova¹  Boris V. Afanasyev¹  Marina O. Popova¹  Vladimir N. Vavilov¹  Natalia I. Zubarovskaya¹  Alisa G. Volkova¹  Nikolay N. Klimko¹  Sergey N. Shiriaev¹  Sofia N. Hostelidi¹ 

关键词: allogeneic HSCT;    autologous HSCT;    invasive fungal infections;    overall survival;   

DOI  :  10.3205/ctt-2010-No9-abstract67

学科分类：肿瘤学

来源: Universitaetsklinikum Hamburg - Eppendorf / University Medical Center Hamburg - Eppendorf

【 摘 要 】

Background:Invasivefungalinfection(IFI)isaleadingcauseofinfection-relatedmortalityfollowinghemopoieticstemcelltransplantation(HSCT).Aim:ToevaluatetheincidenceofIFI,andtheriskfactorsinfluencingoverallsurvival(OS)inpatientsundergoingHSCT.Patientsandmethods:88adultpatients(pts)(medianage32years,range18–67)underwenteitheralloHSCT(39pts)(MRD16pts,MUD21pts,haploRD2pts)orautoHSCT(49pts)aftermyeloablative(31pts)andnon-myeloablative(57pts)conditioning.AtthetimeofHSCT54ofthemwereinCRand34inrelapseofacuteleukemia,lymphoma,andothermalignancies.Results:AhighincidenceofIFIafteralloHSCTvs.autoHSCTwasobserved(56%and24%,respectively)withapredominanceofinvasiveaspergillosis(91%and92%)vs.invasivecandidiasis(4.5%and8%).Factorsassociatedwithasignificant(plt;0.05)decreaseof12-weekOSforallo-andautoHSCTwereneutropeniagt;10days(61%vs.100%),lymphopeniagt;30days(73%vs.97%),anddisseminatedIFI(64%vs.82%).Steroids1mg/kgandrelapseatthetimeofHSCTwereassociatedwithahigherriskofmortalityforthealloHSCTgroup(plt;0.05).TreatmentofIFIwithvoriconazoleimprovedthe12-weekOS(95%vs.57%;plt;0.005)followingalloHSCT,butnotfollowingautoHSCT.Five-yearOSinptsafteralloHSCTwithIFIvs.withoutIFIwas15%vs.38%and48%vs.60%afterautoHSCT(рgt;0.1).Thiswassignificantlyinfluencedbyprofoundlymphopenia(plt;0.001)anddisseminatedIFI(plt;0.001).Conclusions:Neutropenia,lymphopenia,disseminatedIFI,andvoriconazoletherapyareamongthemainriskfactorsinfluencing12-weekand5-yearOSinptswhounderwentallo-andautoHSCT.

【 授权许可】

Unknown