Invasive pulmonary aspergillosis in allogeneic stem cell transplant recipients

Ref ID: 18599

Author:

B.S. Muiña, C. Castilla-Llorente, I. Heras, J.M. Torregrosa,
J. Nieto, F. de Arriba, M. Osma, V. Vicente

Author address:

Hospital J.M. Morales Meseguer (Murcia, ES)

Full conference title:

Annual Meeting of the EBMT, 36th

Abstract:

Background: Invasive pulmonary aspergillosis (IPA) remains
one of the main causes of morbidity and mortality in patients
undergoing allogeneic haematopoietic stem cell transplant
(alloHSCT).
Aims: To determine the incidence and risk factors for IPA in
patients receiving alloHSCT.
Patients and methods: Descriptive, observational and retrospective study which includes 61 consecutive patients who
underwent alloHSCT between January 2005 and December
2008 in our institution. IPA was defi ned as proven or probable according to the European Organization for Research and
Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria. Statistical analysis: qualitative variables were analyzed
using CHI² test and Student”ºs t-test to compare qualitatives vs.
quantitative variable. Risk factors to develop IPA were identifi ed
by univariate and multivariate logistic regression models.
Results: The median age of the 61 patients was 42 years (range,
10-67). The median follow-up was 832 days after transplant
(range, 159-1566). 21 (34%) transplantations were performed
in patients who had early disease (fi rst complete remission, fi rst
chronic-phase or untreated), 74% of them were from related
donors and conditioning regimen was myeloablative in about
47% of the cases. According EORTC/MSG criteria, 9 patients
had proven or probable IPA and the median time to diagnosis
was + 261 days after infusion (range, 32-1020). 50% of them
were transplanted on complete remission and received a myeloablative conditioning regimen. At the time of IPA diagnosis,
6 patients were receiving double immunosuppressive therapy
for graft-versus-host disease (GvHD) which included steroids in
5 of them. Two patients were neutropenic and on relapse after
HSCT and 3 patients had a Cytomegalovirus reactivation concomitant to the IPA. In the univariate analysis, no risk factors
signifi cantly infl uenced the development of IPA. Five patients
were receiving antifungal prophylaxis when IPA was diagnosed
and none of them had previous fungal infection history. IPArelated mortality was 11% (1 patient). All patients were treated
with Voriconazole alone or in combination with other antifungal
drugs and the outcome were positive in all but one patient.

Conclusions: In our series the incidence of IPA was similar to
the one reported by the literature, although the IPA-related mortality was much lower. We could not identify as risk factors for
IPA those reported by others, probably due to the number of
cases.

Abstract Number: R1270

Conference Year: 2010

Link to conference website: NULL

New link: NULL

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