Invasive aspergillosis in patients with hematological malignancies in Slovakia: CELL fungal infection database (FIND) analysis, 2005-2011

Ref ID: 19421

Author:

B. Ziakova,1 E. Bojtarova,1 Z. Racil,2 B. Weinbergerova,2 L.
Drgona,3 L. Masarova,3 E. Tothova,4 J. Gabzdilova,4 D. Sejnova,5
J. Horakova,6 A. Chocholova,6 J. Muzik7 and M. Mistrik1

Author address:

1University Hospital Bratislava, Slovak Republic; 2Department of
Internal Medicine-Hematology and Oncology, University Hospital,
Brno, Czech Republic; 3Second Department of Oncology,
National Cancer Institute, Bratislava, Slovak Republic;
4Depart

Full conference title:

6th Trends in Medical Mycology 2013

Date: 11 October 2014

Abstract:

Objectives Evaluation of risk factors, diagnostic procedures and
treatment outcomes of proven/probable episodes of invasive aspergil-
losis (IA) that occurred in patients with hematological malignancies.
Methods Retrospective analysis of data from 2005 to 2011 at 5
hematology centers in Slovakia.
Results There were 96 cases of IA identified. The majority of underly-
ing hematological disease represented acute leukemia and myelodys-
plastic syndrome (44%), and induction or re-induction treatment
(45%). The most frequent risk factor was neutropenia (57%). Chest
HRCT performed in 85/96 patients at the time of diagnosis detected an
abnormality in all episodes. Lungs were the most frequently affected
site of infection (91%). The dominant findings were bilateral infiltrates
(36%), signs more specific for IA were described less frequently.
Galactomannan (GM) detection in serum and bronchoalveolar
lavage (BAL) were the major methods used in diagnosis assessment.
Considering positive two consecutive serum samples with index of
positivity >0.5, serum GM test was found positive in 73% of cases.
GM test was positive in 31/96 (94%) of obtained BAL fluids (index of
positivity >0.5).
Neutrophil count and antifungal prophylaxis did not affect the
serum GM positivity rate, while the use of mold-active empirical anti-
fungal therapy decreased the serum GM positivity rate. The BAL GM
positivity rate was not influenced by prophylactic nor empirical anti-
fungal treatment administration.
42% of the overall IA cases responded to initial antifungal therapy.
There was only slight difference in response rate between voriconaz-
ole monotherapy and combination of voriconazole and echinocandin
(47% vs 40%).
Conclusion Taking into account IA as an important cause of mor-
bidity and mortality in hematological patients, the identification of
diagnostic and treatment characteristics could improve the outcome
in this group of patients.

Abstract Number: p191

Conference Year: 2013

Link to conference website: NULL

New link: NULL

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