Cytokine pro64257; le of patients with invasive aspergillosis: initial results from the 64257; rst 100 patients recruited into the aspergillosis study; Great Britain

Ref ID: 18630

Author:

M.M. Ceesay, S. Kordasti, L. Berry, J. Wade, M. Smith, G. Mufti,
A. Pagliuca

Author address:

King’s College Hospital (London, UK)

Full conference title:

Annual Meeting of the EBMT, 37th

Abstract:

Objectives: Invasive Aspergillosis (IA) is an important cause of
morbidity and mortality in haemato-oncology patients undergoing haematopoietic stem cell transplantation (HSCT) or highdose chemotherapy. We set up an observational prospective
cohort study in order to improve our diagnostic and management strategies using the EORTC/MSG criteria as a diagnostic
tool. Here we assess the serial cytokine profi le of patients to
evaluate their potential role in the diagnosis and management
of IA.
Methods: All study patients were prospectively recruited and followed up for 149; 4 months after chemotherapy or HSCT and had
baseline and fortnightly follow-up serum samples profi led for
30 infl ammatory cytokines using multiplex bead immunoassays
by Luminex 100TM instrument. The cytokines measured were:
EGF, Eotaxin, FGF, G-CSF, GM-CSF, HGF, IFN-a, IFN-g, IL-
1RA, IL-1b, IL-2, IL-2R, IL-4, IL5, IL6, IL7, IL-8, IL-10, IL-12p40/
p70, IL-13, IL-15, IL-17, IP-10, MCP-1, MIG, MIP-1a, MIP-1b,
Rantes, TNF-a and VEGF. The fi rst hundred patients enrolled
with suffi cient follow up data were included in this initial analysis. We used generalised logistic regression model for binary
outcome of proven/probable and no evidence of IA (R2=0.4355,
P<0.001) adjusting for clustering, age, sex, underlying diagnosis and treatment. Results: The median (range) age was 52.5 (19-73) years and M/F ratio was 58/42. The main diagnosis were AML/MDS (40), Myeloma (23), NHL (17) and aplastic anaemia (9) treated by allogeneic HSCT (43), autologous HSCT (32), chemotherapy (20), and immunosuppressive therapy (5). The diagnosis of invasive fungal infection was based on the revised 2008 EORTC/MSG criteria. The incidence of proven and probable infection was 17% and possible infection accounted for 12%. Eight patients were excluded from analysis because of lack of proper baseline sample. Ten cytokines were found to be signifi - cantly different. Patients with IA were found to have lower IL-1b (P=0.003), IL-10 (P<0.001), IL-12 (P=0.05), IL-17 (P=0.016), IL-15 (P=0.027), INF-a (P=0.05), and GMCSF (P=0.023) but higher IL-6 (P=0.08) and IP-10 (P=0.022). Older age correlated with IA (P=0.014). Conclusion: Overall patients with invasive fungal infection have signifi cantly lower pro-infl ammatory cytokine profi le in the Th1 and Th17 axis and therefore unable to effectively deal with infection. If this profi le is validated in the larger cohort it may be used as a predictive model for targeted anti-fungal prophylaxis.

Abstract Number: P1054

Conference Year: 2011

Link to conference website: NULL

New link: NULL

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