Contributions
Abstract: EP822
Type: E-Poster Presentation
Session title: Infections in hematology (incl. supportive care/therapy)
Background
Invasive aspergillosis (IA) is dominant among fungal disease after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The emergence of new immunosuppressive drugs, the expanding use of antifungal agents with activity against Aspergillus spp. on the one hand, and the improvement of treatment, prophylaxis and diagnostic methods on the other hand affect epidemiology and treatment efficacy of IA.
Aims
To estimate the epidemiology of IA in large cohort of allo-HSCT recipients during 1-year period after allo-HSCT in a retrospective single-center study.
Methods
We analyzed 556 patients underwent allo-HSCT from 2017 to 2019 years in CIC 725. Transplantation from related donor was performed in 109 (20%), from unrelated donor – 286 (50%), haploidentical donor – 161 (30%). The median age - 36 years (18-69), men – 48,7%. The median follow up time was 15,6 months. During the observation period, 40 patients with proven and probable IA were included into analysis. According to EORTC/MSG 2019 criteria 2 proven and 38 probable cases were diagnosed in adults with hematological malignances and non-malignant hematological diseases after allo-HSCT.
Results
Thirty-four (6%) patients had IA before HSCT and the only one patient had IA after allo-HSCT. Incidence of IA during 1-year period after allo-HSCT was 7,1% (40/556). IA more common diagnosed in patients with acute leukemia – 35% and lymphomas – 30%. Most of the patients at the moment of IA diagnosis received antifungal prophylaxis with fluconazole (65%) or posaconazole (17,5%). The main site of infection were lungs 95%, sinuses – 5%. The diagnosis of IA were proved by bronchoalveolar (BAL) or sinuses liquid culture in 32,5% cases, and the etiology were: Aspergillus niger – 6 (46%), Aspergillus fumigatus – 5 (38%), Aspergillus spp. – 2 (16%). The median day of IA onset was day +172 (35-315) after allo-HSCT. Factors significantly associated with higher incidence of IA were CMV-infection (p<0.0001) and acute graft versus host disease (p=0.0478), but not disease status, conditioning regimen, donor type or history of IA. Overall survival at 12 weeks for patients with IA was 85%.
Conclusion
Pre-existing IA had 6% of allo-HSCT recipients. Incidence of IA after allo-HSCT during 1-year period was 7,1% with the median day +172. The main site of infection were lungs, etiology – Aspergillus niger. Only CMV-infection and aGVHD were associated with higher risk of IA in post-transplant period. Overall survival at 12 weeks for patients with IA was 85%.
Keyword(s): Aspergillus, Invasive aspergillosis, Stem cell transplant
Abstract: EP822
Type: E-Poster Presentation
Session title: Infections in hematology (incl. supportive care/therapy)
Background
Invasive aspergillosis (IA) is dominant among fungal disease after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The emergence of new immunosuppressive drugs, the expanding use of antifungal agents with activity against Aspergillus spp. on the one hand, and the improvement of treatment, prophylaxis and diagnostic methods on the other hand affect epidemiology and treatment efficacy of IA.
Aims
To estimate the epidemiology of IA in large cohort of allo-HSCT recipients during 1-year period after allo-HSCT in a retrospective single-center study.
Methods
We analyzed 556 patients underwent allo-HSCT from 2017 to 2019 years in CIC 725. Transplantation from related donor was performed in 109 (20%), from unrelated donor – 286 (50%), haploidentical donor – 161 (30%). The median age - 36 years (18-69), men – 48,7%. The median follow up time was 15,6 months. During the observation period, 40 patients with proven and probable IA were included into analysis. According to EORTC/MSG 2019 criteria 2 proven and 38 probable cases were diagnosed in adults with hematological malignances and non-malignant hematological diseases after allo-HSCT.
Results
Thirty-four (6%) patients had IA before HSCT and the only one patient had IA after allo-HSCT. Incidence of IA during 1-year period after allo-HSCT was 7,1% (40/556). IA more common diagnosed in patients with acute leukemia – 35% and lymphomas – 30%. Most of the patients at the moment of IA diagnosis received antifungal prophylaxis with fluconazole (65%) or posaconazole (17,5%). The main site of infection were lungs 95%, sinuses – 5%. The diagnosis of IA were proved by bronchoalveolar (BAL) or sinuses liquid culture in 32,5% cases, and the etiology were: Aspergillus niger – 6 (46%), Aspergillus fumigatus – 5 (38%), Aspergillus spp. – 2 (16%). The median day of IA onset was day +172 (35-315) after allo-HSCT. Factors significantly associated with higher incidence of IA were CMV-infection (p<0.0001) and acute graft versus host disease (p=0.0478), but not disease status, conditioning regimen, donor type or history of IA. Overall survival at 12 weeks for patients with IA was 85%.
Conclusion
Pre-existing IA had 6% of allo-HSCT recipients. Incidence of IA after allo-HSCT during 1-year period was 7,1% with the median day +172. The main site of infection were lungs, etiology – Aspergillus niger. Only CMV-infection and aGVHD were associated with higher risk of IA in post-transplant period. Overall survival at 12 weeks for patients with IA was 85%.
Keyword(s): Aspergillus, Invasive aspergillosis, Stem cell transplant