Lower respiratory tract respiratory virus infections increase the risk of invasive aspergillosis after a reduced-intensity allogeneic hematopoietic SCT
Por:
Martino, R, Pinana, JL, Parody, R, Valcarcel, D, Sureda, A, Brunet, S, Briones, J, Delgado, J, Sanchez, F, Rabella, N, Sierra, J
Publicada:
1 dic 2009
Resumen:
We have analyzed the incidence and risk factors for the occurrence of invasive aspergillosis (IA) among 219 consecutive recipients of an allogeneic hematopoietic SCT after a reduced-intensity conditioning regimen (Allo-RIC). Twenty-seven patients developed an IA at a median of 218 days (range 24-2051) post-Allo-RIC, for a 4-year incidence of 13% (95% confidence interval 4-24%). In multivariate analysis, risk factors for developing IA were steroid therapy for moderate-to-severe graft vs host disease (GVHD) (Hazard Ratio (HR) 2.9, P = 0.03), occurrence of a lower respiratory tract infection (LRTI) by a respiratory virus (RV) (HR 4.3, P < 0.01) and CMV disease (HR 2.8, P = 0.03). Variables that decreased survival after Allo-RIC were advanced disease phase (HR 1.9, P = 0.02), steroid therapy for moderate-to-severe GVHD (HR 2.2, P < 0.01), not developing chronic GVHD (HR 4.3, P < 0.01), occurrence of LRTI by an RV (HR 3.4, P < 0.01 ) and CMV disease (HR 2, P 0.01), whereas occurrence of IA had no effect on survival (P = 0.5). Our results show that IA is a common infectious complication after an Allo-RIC, which occurs late post-transplant and may not have a strong effect on survival. An important observation is the possible role of LRTI by conventional RVs as risk factors for IA. Bone Marrow Transplantation (2009) 44, 749-756; doi:10.1038/bmt.2009.78; published online 27 April 2009
Filiaciones:
Martino, R:
Autonomous Univ Barcelona, Div Clin Hematol, Hosp St Creu & St Pau, Barcelona 8025, Catalunya, Spain
Pinana, JL:
Autonomous Univ Barcelona, Div Clin Hematol, Hosp St Creu & St Pau, Barcelona 8025, Catalunya, Spain
Parody, R:
Autonomous Univ Barcelona, Div Clin Hematol, Hosp St Creu & St Pau, Barcelona 8025, Catalunya, Spain
Valcarcel, D:
Autonomous Univ Barcelona, Div Clin Hematol, Hosp St Creu & St Pau, Barcelona 8025, Catalunya, Spain
Sureda, A:
Autonomous Univ Barcelona, Div Clin Hematol, Hosp St Creu & St Pau, Barcelona 8025, Catalunya, Spain
Brunet, S:
Autonomous Univ Barcelona, Div Clin Hematol, Hosp St Creu & St Pau, Barcelona 8025, Catalunya, Spain
Briones, J:
Autonomous Univ Barcelona, Div Clin Hematol, Hosp St Creu & St Pau, Barcelona 8025, Catalunya, Spain
Delgado, J:
Autonomous Univ Barcelona, Div Clin Hematol, Hosp St Creu & St Pau, Barcelona 8025, Catalunya, Spain
Sanchez, F:
Autonomous Univ Barcelona, Dept Microbiol, Hosp St Creu & St Pau, Barcelona 8025, Catalunya, Spain
Rabella, N:
Autonomous Univ Barcelona, Dept Microbiol, Hosp St Creu & St Pau, Barcelona 8025, Catalunya, Spain
Sierra, J:
Autonomous Univ Barcelona, Div Clin Hematol, Hosp St Creu & St Pau, Barcelona 8025, Catalunya, Spain
Green Published, Bronze
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