Lymphocyte defects and IFD in transplant setting

Ref ID: 19467

Author:

A.J. Ullmann

Author address:

Julius-Maximilians University, Wurzburg, Germany

Full conference title:

6th Trends in Medical Mycology 2013

Date: 11 October 2014

Abstract:

The incidence of IA after allogeneic HSCT is reported to be 10% and
higher, and despite the treatment with different classes and combina-
tions of antifungal drugs the mortality in this patient population
reaches up to 60% to 80%. The high mortality rates in this patient
population document the limited efficacy of primary antifungal che-
motherapy, in particular in patients with a long-lasting compromised
immune system as seen after allogeneic HSCT.
Prolonged severe neutropenia is the most important risk factor for
the development of IA, the use of T cell depleted grafts, corticoster-
oids and other immune suppressive drugs have been identified as fur-
ther risk factors for IA in the later course after HSCT, even in non-
neutropenic patients. In fact, up to two thirds of patients with IA
diagnosed after allogeneicHSCT are not neutropenic, and the median
time of diagnosis of IA after HSCT is 82 days (range, 3 – 6542 days).
It has become clear that T cells, especially T cells of the T-helper type
1 (TH1), significantly contribute to the defense against fungal infec-
tions. It has been shown that patients with IA and a TH1 response,
which is characterized by increased interferon (IFN)-? and low inter-
leukin (IL)-10 production, had a better outcome than patients with a
TH2 to response, which is characterized by low IFN-? and increased
IL-10. Notably, the number of anti-Aspergillus TH1 cells remains low
after HSCT for a prolonged period of time.

Abstract Number: w16.3

Conference Year: 2013

Link to conference website: NULL

New link: NULL

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