Invasive aspergillosis before allogeneic hematopoietic stem cell transplantation: 10-year experience at a single transplant center

Takahiro Fukuda, Michael Boeckh, Katherine A. Guthrie, Debra K. Mattson, Stephanie Owens, Anna Wald, Brenda M. Sandmaier, Lawrence Corey, Rainer F. Storb, Kieren Marr

Research output: Contribution to journalArticle

Abstract

Hematopoietic stem cell transplantation (HCT) in patients with prior or active invasive aspergillosis (IA) is a frequent consideration. We reviewed outcomes of 2319 patients who underwent transplantation between 1992 and 2001 in our institution, among whom 45 patients (1.9%) had a known history of IA before HCT. Posttransplantation IA occurred in 13 of these 45 patients with a pretransplantation history (29%). Nine infections were considered recurrent by anatomic site and timing. Compared with all other patients who received allogeneic HCT during the same period, patients with histories of IA had lower overall survival (56% versus 77%; P = .0001) and higher transplant-related mortality (TRM; 38% versus 21%; P = .0001) 100 days after HCT, associated mainly with IA and other pulmonary complications. Among patients with prior IA, posttransplantation IA occurred more frequently in patients who received 1 month of antifungal therapy and had resolution of radiographic abnormalities were not different from those of patients without prior IA. Patients with prior IA who received conditioning with total body irradiation (TBI) had higher TRM compared with those who received nonmyeloablative and non-total body irradiation-based regimens (16/31 versus 2/14; P = .024). Thus, the duration of antifungal therapy before transplantation, the resolution of radiographic abnormalities, and conditioning regimens are important variables to consider for minimizing the risk for IA recurrence and TRM after allogeneic HCT.

Original languageEnglish (US)
Pages (from-to)494-503
Number of pages10
JournalBiology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Volume10
Issue number7
DOIs
StatePublished - Jul 2004
Externally publishedYes

Fingerprint

Aspergillosis
Hematopoietic Stem Cell Transplantation
Transplants
Transplantation
Invasive Pulmonary Aspergillosis
Whole-Body Irradiation
History
Recurrence

Keywords

  • Allogeneic
  • Hematopoietic cell transplantation
  • History
  • Invasive aspergillosis

ASJC Scopus subject areas

  • Transplantation

Cite this

Invasive aspergillosis before allogeneic hematopoietic stem cell transplantation : 10-year experience at a single transplant center. / Fukuda, Takahiro; Boeckh, Michael; Guthrie, Katherine A.; Mattson, Debra K.; Owens, Stephanie; Wald, Anna; Sandmaier, Brenda M.; Corey, Lawrence; Storb, Rainer F.; Marr, Kieren.

In: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, Vol. 10, No. 7, 07.2004, p. 494-503.

Research output: Contribution to journalArticle

Fukuda, Takahiro ; Boeckh, Michael ; Guthrie, Katherine A. ; Mattson, Debra K. ; Owens, Stephanie ; Wald, Anna ; Sandmaier, Brenda M. ; Corey, Lawrence ; Storb, Rainer F. ; Marr, Kieren. / Invasive aspergillosis before allogeneic hematopoietic stem cell transplantation : 10-year experience at a single transplant center. In: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 2004 ; Vol. 10, No. 7. pp. 494-503.
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