TY - JOUR
T1 - Impact of the intensity of the pretransplantation conditioning regimen in patients with prior invasive aspergillosis undergoing allogeneic hematopoietic stem cell transplantation
T2 - A retrospective survey of the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation
AU - Martino, Rodrigo
AU - Parody, Rocio
AU - Fukuda, Takahiro
AU - Maertens, Johan
AU - Theunissen, Koen
AU - Ho, Aloysius
AU - Mufti, Ghulam J.
AU - Kroger, Nicolaus
AU - Zander, Arnold R.
AU - Heim, Dominik
AU - Paluszewska, Monika
AU - Selleslag, Dominik
AU - Steinerova, Katerina
AU - Ljungman, Per
AU - Cesaro, Simone
AU - Nihtinen, Anna
AU - Cordonnier, Catherine
AU - Vazquez, Lourdes
AU - López-Duarte, Monica
AU - Lopez, Javier
AU - Cabrera, Rafael
AU - Rovira, Montserrat
AU - Neuburger, Stefan
AU - Cornely, Oliver
AU - Hunter, Ann E.
AU - Marr, Kieren A.
AU - Dornbusch, Hans Jürgen
AU - Einsele, Hermann
PY - 2006/11/1
Y1 - 2006/11/1
N2 - In this retrospective study, we analyzed the outcomes of 129 patients who underwent an allogeneic hematopoietic stem cell transplantation (allo-HSCT) and had a history of probable or proven invasive aspergillosis (IA), of whom 57 (44%) received a reduced-intensity conditioning (RIC). Overall, 27 patients with IA progressed after the allo-HSCT (cumulative incidence [CumInc] at 2 years, 22%). The variables that increased the 2-year CumInc of IA progression were (1) longer duration of neutropenia after transplantation; (2) advanced status of the underlying disease; and (3) less than 6 weeks from start of systemic anti-Aspergillus therapy and the allo-HSCT. In addition, (4) conventional myeloablative conditioning increased the risk of progression early after transplantation (before day 30) only, while 3 variables increased the risk beyond day 30 were (5) cytomegalovirus disease; (6) bone marrow or cord blood as source of stem cells; and (7) grades II to IV acute graft-versus-host disease (GVHD). A risk model for progression was generated, defined as low (0-1 risk factors, 6% incidence), intermediate (2-3 risk factors, 27% incidence), or high risk (≥ 3 risk factors, 72% incidence [P < .001]). These findings may help in the interpretation and design of future studies on secondary prophylaxis of IA after an allo-HSCT.
AB - In this retrospective study, we analyzed the outcomes of 129 patients who underwent an allogeneic hematopoietic stem cell transplantation (allo-HSCT) and had a history of probable or proven invasive aspergillosis (IA), of whom 57 (44%) received a reduced-intensity conditioning (RIC). Overall, 27 patients with IA progressed after the allo-HSCT (cumulative incidence [CumInc] at 2 years, 22%). The variables that increased the 2-year CumInc of IA progression were (1) longer duration of neutropenia after transplantation; (2) advanced status of the underlying disease; and (3) less than 6 weeks from start of systemic anti-Aspergillus therapy and the allo-HSCT. In addition, (4) conventional myeloablative conditioning increased the risk of progression early after transplantation (before day 30) only, while 3 variables increased the risk beyond day 30 were (5) cytomegalovirus disease; (6) bone marrow or cord blood as source of stem cells; and (7) grades II to IV acute graft-versus-host disease (GVHD). A risk model for progression was generated, defined as low (0-1 risk factors, 6% incidence), intermediate (2-3 risk factors, 27% incidence), or high risk (≥ 3 risk factors, 72% incidence [P < .001]). These findings may help in the interpretation and design of future studies on secondary prophylaxis of IA after an allo-HSCT.
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U2 - 10.1182/blood-2006-03-008706
DO - 10.1182/blood-2006-03-008706
M3 - Article
C2 - 16720833
AN - SCOPUS:33750515267
SN - 0006-4971
VL - 108
SP - 2928
EP - 2936
JO - Blood
JF - Blood
IS - 9
ER -