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.

TY - JOUR

T1 - 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.

AU - Martino, Rodrigo

AU - Parody, Rocio

AU - Fukuda, Takahiro

AU - Maertens, Johan

AU - Theunissen, Koen

AU - Ho, Aloysius

AU - Mufti, Ghulam J

AU - Kröger, 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

Y1 - 2006

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 (> 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.

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 (> 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.

M3 - SCORING: Zeitschriftenaufsatz

VL - 108

SP - 2928

EP - 2936

JO - BLOOD

JF - BLOOD

SN - 0006-4971

IS - 9

M1 - 9

ER -