Invasive fungal disease in patients undergoing umbilical cord blood transplantation after myeloablative conditioning regimen

Autor:	José Luis Piñana, Inés Gómez, Rebeca Rodríguez-Veiga, Miguel A. Sanz, Guillermo Sanz, Carlos Carretero, Aitana Balaguer, Eva Gonzalez, Manuel Guerreiro, Lorenzo Ji, Pilar Solves, Juan Montoro, Pau Montesinos, Jaime Sanz, Miguel Salavert
Rok vydání:	2019
Předmět:	Adult Male medicine.medical_specialty Transplantation Conditioning Multivariate analysis Adolescent Graft vs Host Disease Disease Aspergillosis Severity of Illness Index Gastroenterology Young Adult 03 medical and health sciences 0302 clinical medicine Anti-Infective Agents Risk Factors Cause of Death Internal medicine medicine Humans Public Health Surveillance Cumulative incidence Retrospective Studies business.industry Umbilical Cord Blood Transplantation Incidence Hematology General Medicine Middle Aged medicine.disease Patient Outcome Assessment Graft-versus-host disease Mycoses 030220 oncology & carcinogenesis Female Cord Blood Stem Cell Transplantation Stem cell Complication business 030215 immunology
Zdroj:	European Journal of Haematology. 102:331-340
ISSN:	0902-4441
DOI:	10.1111/ejh.13202
Popis:	OBJECTIVE Characteristics and risk factors (RFs) of invasive fungal disease (IFD) have been little studied in the setting of umbilical cord blood transplantation (UCBT). METHOD We retrospectively included 205 single-unit myeloablative UCBT recipients with a median follow-up of 64 months. RESULTS Fifty-six episodes of IFD were observed in 48 patients (23%) at a median time of 123 days after stem cell infusion. Invasive mold disease (IMD) occurred in 42 cases, 38 of them (90%) caused by invasive aspergillosis whereas invasive yeast disease (IYD) occurred in 14 cases, most of them due to candidemia (n = 12, 86%). The 5-year cumulative incidence of IFD, IMDs, and IYDs was 24% 19%, and 7%, respectively. In multivariate analysis, three RFs for IMDs were identified: age >30 years (HR 3.5, P = 0.017), acute grade II-IV graft-versus-host disease (HR 2.3, P = 0.011), and ≥1 previous transplant (HR 3.1, P = 0.012). The probability of IMDs was 2.5%, 14%, and 33% for recipients with none, 1, or 2-3 RFs, respectively (P
Databáze:	OpenAIRE
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