A New Risk Score for Invasive Aspergillosis in Patients with Haematological Malignancies.

Marta Stanzani, Mauro Fiacchini, Fabio Tumietto, Pierluigi Viale, Michele Baccarani, and Nicola Vianelli

Author address: 

1 Hematology, Institute of Haematology and Clinical Oncology Lorenzo e Ariosto Serí gnoli, Sant’Orsola-Malpighi Hospital, University of Bolog, Bologna, Italy, 2 Hematology, Hematology, Institute of Haematology and Clinical Oncology Lorenzo e Ariost;NULL;2013-04-17 12:35:16;NULL;NULL;1469;NULL; 14446;Conference Proceedings;Marco Montillo, Francesca Ricci, Alessandra Tedeschi, Sara Miqueleiz, Giovanni Grillo, Eleonora Vismara, Antonino Greco, Silvio Veronese, and Enrica Morra

Abstract: 

Invasive fungal infections, particularly invasive aspergillosis (IA), are frequent complications in immunocompromised patients. The identification of risk factors for IA is crucial to select patients who will benefit from different antifungal treatment. Retrospectively, we studied 1,194 hospitalizations registered at our Institution between March 2005 and December 2007, involving 618 patients affected by haematological malignancies (acute leukemia 34%, lymphoma 34%, multiple myeloma 24%, chronic myeloid leukemia 5%, severe aplastic anemia 1.5%, chronic lymphocytic leukemia 1.5%), with the purpose of developing a risk score able to stratify patients in categories at different risk for IA. Every febrile episode and every hospitalization without febrile episodes were recorded as single phase, for a total number of 1,409 phases. In 53% of the phases, the haematological malignancy was fully active (first presentation or resistant disease), and the main treatments administrated were: induction chemotherapy (18%), consolidation chemotherapy (20%), salvage chemotherapy (15%), HSCT in 33% (autologous: 21%; allogeneic: 12%). In 13% of the hospitalizations, patients did not receive chemotherapy but supportive cares. Seventeen variables were assessed as risk factors for IA according to literature data and to local clinical practice (age, smoking habit, type of job, previous IA, prolonged steroids treatment, diabetes, type of haematological malignancy, disease staus, type of treatment, prolonged neutropenia and lymphocytopenia, acute or chronic GvHD, CMV infection, mucositis, presence or absence of HEPA filter, proximity of building sites to the Haematology Unit) receiving a score ranging from 0 to 2. Summing the weighted points assigned to each variable, a total score (TSCORE08) was calculated for each phase and allowed to empirically identify 3 groups of patients at low (1 to 8), intermediate (8.5 to 11.5), and high (12 to 17) risk for IA, and was significantly higher in patients with IA (p
2008

Full conference title: 

50th American Society of Haematologists Annual Meeting
    • ASH 50th (2008)