Fungal infection with an incidence about 15%; remains a major cause of infectious death in the allogeneic stem cell transplantation. The risk has considered to be lower in the autologus transplantation. We aimed to fi nd the fungal infection rates during the construction of another building near a transplantation unit and asess the outcomes of antifungal prophylaxsis. Sixty four autologus and thirty four allogeneic transplantation patients were evaluated respectively. In the autologus group, Female/Male: 23/41, median age was 51 years (36-70). Diagnosis of patients were Non Hodgkin lymphoma/Hodgkin lymphoma/multil myeloma; 11/6/47 respectively. Patients were given amphotericin deoxycholate ( 0.3 mg/kg) for fi ve months after the construction and fl uconazole (200 mg ) in the rest 3 months. In the allogeneic transplantation group Female /Male:15/19 Median age was 30 (19-58)years. Diagnosis of patients were Acute myeloblastic leukemia/acute lymphoblastic leukemia/ Myelofi brosis/myelodisplastic syndrome/Hodgkin/Aplastic anemia/Paroksismal nocturnal hemoglobinuria: 18/7/2/1/1/2/2/1. Five patients had unrelated HLA matched peripheral stem cell transplantation and three patients had unrelated cord blood transplantation. Six patients were given secondary prophilaxysis with voriconazole. The rest of were given amphotericin deoxycholate( 0.3 mg/kg) as primary propfi laxysis for 8 months after the construction. In the autologus patients group only two (3%) patients were diagnosed as invasive pulmonary aspergillus infection by computerized tomography; one in the amphotericin group and the other in the fl uconazole. In the allogeneic secondary prophilaxysis group, one patient had progressive fungal infection and died because of bacterial sepsis, respiratory failure. In the primary prophylaxsis group fi ve patients (17%) diagnosed as invasive fungal infection during the follow up. Median time from hospitalization to diagnosis were 30 days and median time from transplantation to diagnosis were 16 days. We showed that during the construction period amphotericin prophylaxsis must be given to allogeneic transplantation patients but it has no superiority for autologus patients. It has to be decided by the physician according to patient characteristics.
Full conference title:
Annual Meeting of the EBMT, 37th
- EBMT 37th (2011)