1. Pre-existing invasive fungal infection is not a contraindication for allogeneic HSCT for patients with hematologic malignancies: a CIBMTR study
- Author
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Maziarz, RT, Brazauskas, R, Chen, M, McLeod, AA, Martino, R, Wingard, JR, Aljurf, M, Battiwalla, M, Dvorak, CC, Geroge, B, Guinan, EC, Hale, GA, Lazarus, HM, Lee, J-W, Liesveld, JL, Ramanathan, M, Reddy, V, Savani, BN, Smith, FO, Strasfeld, L, Taplitz, RA, Ustun, C, Boeckh, MJ, Gea-Banacloche, J, Lindemans, CA, Auletta, JJ, and Riches, ML
- Subjects
Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Clinical Sciences ,Regenerative Medicine ,Cancer ,Infectious Diseases ,Transplantation ,Hematology ,Rare Diseases ,Infection ,Good Health and Well Being ,Adolescent ,Adult ,Aged ,Allografts ,Aspergillosis ,Aspergillus ,Candida ,Candidiasis ,Child ,Child ,Preschool ,Cord Blood Stem Cell Transplantation ,Disease-Free Survival ,Female ,Hematologic Neoplasms ,Humans ,Infant ,Male ,Middle Aged ,Registries ,Survival Rate ,Oncology and Carcinogenesis ,Immunology ,Cardiovascular medicine and haematology ,Oncology and carcinogenesis - Abstract
Patients with prior invasive fungal infection (IFI) increasingly proceed to allogeneic hematopoietic cell transplantation (HSCT). However, little is known about the impact of prior IFI on survival. Patients with pre-transplant IFI (cases; n=825) were compared with controls (n=10247). A subset analysis assessed outcomes in leukemia patients pre- and post 2001. Cases were older with lower performance status (KPS), more advanced disease, higher likelihood of AML and having received cord blood, reduced intensity conditioning, mold-active fungal prophylaxis and more recently transplanted. Aspergillus spp. and Candida spp. were the most commonly identified pathogens. 68% of patients had primarily pulmonary involvement. Univariate and multivariable analysis demonstrated inferior PFS and overall survival (OS) for cases. At 2 years, cases had higher mortality and shorter PFS with significant increases in non-relapse mortality (NRM) but no difference in relapse. One year probability of post-HSCT IFI was 24% (cases) and 17% (control, P
- Published
- 2017