Title: Impact of the intensity of the pretransplantation conditioning regimen in patients with prior invasive aspergillosis undergoing allogeneic hematopoietic stem cell transplantation: A retrospective survey of the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation
Authors: Martino, Rodrigo ×
Parody, Rocio
Fukuda, Takahiro
Maertens, Johan
Theunissen, Koen
Ho, Aloysius
Mufti, Ghulam J
Kroger, Nicolaus
Zander, Arnold R
Heim, Dominik
Paluszewska, Monika
Selleslag, Dominik
Steinerova, Katerina
Ljungman, Per
Cesaro, Simone
Nihtinen, Anna
Cordonnier, Catherine
Vazquez, Lourdes
López-Duarte, Monica
Lopez, Javier
Cabrera, Rafael
Rovira, Montserrat
Neuburger, Stefan
Cornely, Oliver
Hunter, Ann E
Marr, Kieren A
Dornbusch, Hans Jürgen
Einsele, Hermann #
Issue Date: Nov-2006
Publisher: W.B. Saunders
Series Title: Blood vol:108 issue:9 pages:2928-2936
Abstract: 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 (> or = 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.
ISSN: 0006-4971
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Hematology Section (-)
× corresponding author
# (joint) last author

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