Contributions
Abstract: PB2047
Type: Publication Only
Background
Invasive aspergillosis is the predominant invasive fungal infection in patients with haematological malignancies, including patients with B-cell lymphoma.
Aims
To study clinical and laboratory features of invasive aspergillosis (IA) in patients with B-cell lymphoma.
Methods
The study included 57 patients with Hodgkin lymphoma (HL), age from 16 to 65 years (median – 33), and 51 patients with non-Hodgkin lymphoma (NHL), age from 19 to 74 years (median – 50). For the IA diagnosis criteria EORTS/MSG 2008 were used.
Results
Before the development of IA all patients in both groups received cytostatic chemotherapy, the average number of courses – 6. The main risk factors for IA in patients with HL and NHL were: prolonged lymphocytopenia (70% vs 48%), neutropenia (64% vs 71%), glucocorticosteroids use (61% vs 85%), and B-symptoms (63% vs 48%). In most cases nosocomial IA was diagnosed in both groups (65% vs 83%). The main etiological agents were: A. fumigatus (50% vs 39%), A. niger (43% vs 33%), and A. flavus (7% vs 8%). The lungs were involved in 100% cases, 6% NHL patients had ≥2 organs involvement. Galactomannan test was positive in BAL fluid in 75% patients with HL and in 78% patients with NHL. The presence of septated mycelium was observed at microscopy of BAL in 13% vs 22% patients with IA. Aspergillus spp. in BAL culture was obtained in 27% vs 47% patients with IA. Clinical manifestation of IA was nonspecific in both groups: fever (83% vs 76%), cough (75% vs 59%), dyspnea (50% vs 40%), bronchial obstruction (4% vs 9%), and hemoptysis (2% vs 10%). "Probable" IA was diagnosed in 98% of cases, "proven" – in 2% in HL patients, 88% and 12% in NHL patients. Antifungal therapy received 100% patients. The main antifungal drug was voriconazole - 88% vs 98% cases. Overall 12-weeks survival in patients with Hodgkin lymphoma was 84%, in patients with non-Hodgkin lymphoma - 81%.
Conclusion
The main risk factors for IA in patients with HL and NHL were prolonged lymphocytopenia (70% vs 48%), neutropenia (64% vs 71%), steroids use (61% vs 85%), and B-symptoms (63% vs 48%). Etiology agents were A. fumigatus (50% vs 39%), A. niger (43% vs 33%), and A. flavus (7% vs 8%). Clinical symptoms were nonspecific. The overall 12-weeks survival rate in patients with HL was 84%, in patients with NHL – 81%.
Session topic: 31. Infectious diseases, supportive care
Abstract: PB2047
Type: Publication Only
Background
Invasive aspergillosis is the predominant invasive fungal infection in patients with haematological malignancies, including patients with B-cell lymphoma.
Aims
To study clinical and laboratory features of invasive aspergillosis (IA) in patients with B-cell lymphoma.
Methods
The study included 57 patients with Hodgkin lymphoma (HL), age from 16 to 65 years (median – 33), and 51 patients with non-Hodgkin lymphoma (NHL), age from 19 to 74 years (median – 50). For the IA diagnosis criteria EORTS/MSG 2008 were used.
Results
Before the development of IA all patients in both groups received cytostatic chemotherapy, the average number of courses – 6. The main risk factors for IA in patients with HL and NHL were: prolonged lymphocytopenia (70% vs 48%), neutropenia (64% vs 71%), glucocorticosteroids use (61% vs 85%), and B-symptoms (63% vs 48%). In most cases nosocomial IA was diagnosed in both groups (65% vs 83%). The main etiological agents were: A. fumigatus (50% vs 39%), A. niger (43% vs 33%), and A. flavus (7% vs 8%). The lungs were involved in 100% cases, 6% NHL patients had ≥2 organs involvement. Galactomannan test was positive in BAL fluid in 75% patients with HL and in 78% patients with NHL. The presence of septated mycelium was observed at microscopy of BAL in 13% vs 22% patients with IA. Aspergillus spp. in BAL culture was obtained in 27% vs 47% patients with IA. Clinical manifestation of IA was nonspecific in both groups: fever (83% vs 76%), cough (75% vs 59%), dyspnea (50% vs 40%), bronchial obstruction (4% vs 9%), and hemoptysis (2% vs 10%). "Probable" IA was diagnosed in 98% of cases, "proven" – in 2% in HL patients, 88% and 12% in NHL patients. Antifungal therapy received 100% patients. The main antifungal drug was voriconazole - 88% vs 98% cases. Overall 12-weeks survival in patients with Hodgkin lymphoma was 84%, in patients with non-Hodgkin lymphoma - 81%.
Conclusion
The main risk factors for IA in patients with HL and NHL were prolonged lymphocytopenia (70% vs 48%), neutropenia (64% vs 71%), steroids use (61% vs 85%), and B-symptoms (63% vs 48%). Etiology agents were A. fumigatus (50% vs 39%), A. niger (43% vs 33%), and A. flavus (7% vs 8%). Clinical symptoms were nonspecific. The overall 12-weeks survival rate in patients with HL was 84%, in patients with NHL – 81%.
Session topic: 31. Infectious diseases, supportive care