Full Text:   <1861>

Summary:  <1571>

CLC number: R55

On-line Access: 2015-09-05

Received: 2015-01-04

Revision Accepted: 2015-06-09

Crosschecked: 2015-08-17

Cited: 6

Clicked: 4516

Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

He Huang

http://orcid.org/0000-0002-2723-1621

-   Go to

Article info.
Open peer comments

Journal of Zhejiang University SCIENCE B 2015 Vol.16 No.9 P.796-804

http://doi.org/10.1631/jzus.B1500005


Invasive fungal infection in allogeneic hematopoietic stem cell transplant recipients: single center experiences of 12 years


Author(s):  Ji-min Shi, Xu-ying Pei, Yi Luo, Ya-min Tan, Ru-xiu Tie, Jing-song He, Wei-yan Zheng, Jie Zhang, Zhen Cai, Mao-fang Lin, He Huang

Affiliation(s):  Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China

Corresponding email(s):   huanghe@zju.edu.cn

Key Words:  Invasive fungal infection, Allogeneic hematopoietic stem cell transplantation, Incidence, Risk factors


Ji-min Shi, Xu-ying Pei, Yi Luo, Ya-min Tan, Ru-xiu Tie, Jing-song He, Wei-yan Zheng, Jie Zhang, Zhen Cai, Mao-fang Lin, He Huang. Invasive fungal infection in allogeneic hematopoietic stem cell transplant recipients: single center experiences of 12 years[J]. Journal of Zhejiang University Science B, 2015, 16(9): 796-804.

@article{title="Invasive fungal infection in allogeneic hematopoietic stem cell transplant recipients: single center experiences of 12 years",
author="Ji-min Shi, Xu-ying Pei, Yi Luo, Ya-min Tan, Ru-xiu Tie, Jing-song He, Wei-yan Zheng, Jie Zhang, Zhen Cai, Mao-fang Lin, He Huang",
journal="Journal of Zhejiang University Science B",
volume="16",
number="9",
pages="796-804",
year="2015",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1500005"
}

%0 Journal Article
%T Invasive fungal infection in allogeneic hematopoietic stem cell transplant recipients: single center experiences of 12 years
%A Ji-min Shi
%A Xu-ying Pei
%A Yi Luo
%A Ya-min Tan
%A Ru-xiu Tie
%A Jing-song He
%A Wei-yan Zheng
%A Jie Zhang
%A Zhen Cai
%A Mao-fang Lin
%A He Huang
%J Journal of Zhejiang University SCIENCE B
%V 16
%N 9
%P 796-804
%@ 1673-1581
%D 2015
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1500005

TY - JOUR
T1 - Invasive fungal infection in allogeneic hematopoietic stem cell transplant recipients: single center experiences of 12 years
A1 - Ji-min Shi
A1 - Xu-ying Pei
A1 - Yi Luo
A1 - Ya-min Tan
A1 - Ru-xiu Tie
A1 - Jing-song He
A1 - Wei-yan Zheng
A1 - Jie Zhang
A1 - Zhen Cai
A1 - Mao-fang Lin
A1 - He Huang
J0 - Journal of Zhejiang University Science B
VL - 16
IS - 9
SP - 796
EP - 804
%@ 1673-1581
Y1 - 2015
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1500005


Abstract: 
invasive fungal infection (IFI) is a growing cause of morbidity and mortality among patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We retrospectively reviewed the records of 408 patients undergoing allo-HSCTs during the period November 1998 to December 2009, analyzed the incidence and risk factors of IFI, and examined the impact of IFI on overall survival. A total of 92 (22.5%) episodes suffered proven or probable IFI (4 patients were proven, 88 patients were probable). Candida was the most common pathogen for early IFI, and mold was the most frequent causative organism for late IFI. A prior history of IFI, human leukocyte antigen (HLA) mismatch, long-time neutropenia, and acute graft-versus-host-disease (GVHD) were risk factors for early IFI. A prior history of IFI, corticosteroid therapy, cytomegalovirus (CMV) disease, and chronic GVHD were risk factors for late IFI. IFI-related mortality was 53.26%. The 12-year overall survival (OS) rate for IFI was significantly lower than that of patients without IFI (41.9% vs. 63.6%, P<0.01).

异基因造血干细胞移植术后侵袭性真菌感染的流行病学:单中心12年研究结果

目的:回顾性分析了浙江大学医学院附属第一医院骨髓移植中心1998年至2009年接受造血干细胞移植(HSCT)发生侵袭性真菌感染(IFI)的患者资料,评估HSCT后IFI发病情况、流行病学特征及危险因素,以期寻找病原菌特点及相关的危险因素,为制定更有针对性的预防治疗策略提供依据。
创新点:首次对本中心异基因HSCT后的IFI感染情况进行统计分析,研究年限长,样本量较大;另作为国内较成熟的移植中心之一,本中心的研究结果对国内异基因HSCT后IFI感染情况有较大的参考意义。
方法:对1998年11月至2009年12月在本移植中心接受异基因HSCT的408例患者进行观察分析,总结HSCT后IFI发病情况和病原菌分布,并采用多因素分析判断危险因素。
结论:本研究显示IFI与HSCT预后明显相关,HSCT后不同时期IFI病原菌分布及危险因素存在差异。临床应根据IFI病原学特点及HSCT后时间分布特点,采取不同的策略,更有针对性地用药及开始治疗,从而改善预后。

关键词:侵袭性真菌感染;异基因造血干细胞移植;危险因素

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Ascioglu, S., Rex, J.H., de Pauw, B., et al., 2002. Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin. Infect. Dis., 34(1):7-14.

[2]Bjorklund, A., Aschan, J., Labopin, M., et al., 2007. Risk factors for fatal infectious complications developing late after allogeneic stem cell transplantation. Bone Marrow Transplant., 40(11):1055-1062.

[3]Dagenais, T.R., Keller, N.P., 2009. Pathogenesis of Aspergillus fumigatus in invasive aspergillosis. Clin. Microbiol. Rev., 22(3):447-465.

[4]Fukuda, T., Boeckh, M., Carter, R.A., et al., 2003. Risks and outcomes of invasive fungal infections in recipients of allogeneic hematopoietic stem cell transplants after nonmyeloablative conditioning. Blood, 102(3):827-833.

[5]Garcia-Vidal, C., Upton, A., Kirby, K.A., et al., 2008. Epidemiology of invasive mold infections in allogeneic stem cell transplant recipients: biological risk factors for infection according to time after transplantation. Clin. Infect. Dis., 47(8):1041-1050.

[6]Gratwohl, A., Brand, R., Frassoni, F., et al., 2005. Cause of death after allogeneic haematopoietic stem cell transplantation (HSCT) in early leukaemias: an EBMT analysis of lethal infectious complications and changes over calendar time. Bone Marrow Transplant., 36(9):757-769.

[7]Hovi, L., Saarinen-Pihkala, U.M., Vettenranta, K., et al., 2000. Invasive fungal infection in pediatric BMT recipients: single center experience of 10 years. Bone Marrow Transplant., 26(9):999-1004.

[8]Jantunen, E., Ruutu, P., Niskanen, L., et al., 1997. Incidence and risk factors for invasive fungal infections in allogeneic BMT recipients. Bone Marrow Transplant., 19(8):801-808.

[9]Koldehoff, M., Zakrzewski, J.L., 2005. Modern management of respiratory failure due to pulmonary mycoses following allogeneic hematopoietic stem-cell transplantation. Am. J. Hematol., 79(2):158-163.

[10]Kontoyiannis, D.P., Marr, K.A., Park, B.J., et al., 2010. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001‒2006: overview of the Transplant Associated Infection Surveillance Network (TRANSNET) Database. Clin. Infect. Dis., 50(8):1091-1100.

[11]Lin, S.J., Schranz, J., Teutsch, S.M., 2001. Aspergillosis case-fatality rate: systematic review of the literature. Clin. Infect. Dis., 32(3):358-366.

[12]Marr, K.A., Carter, R.A., Boeckh, M., et al., 2002. Invasive aspergillosis in allogeneic stem cell transplant recipients: changes in epidemiology and risk factors. Blood, 100(13):4358-4366.

[13]Neofytos, D., Horn, D., Anaissie, E., et al., 2009. Epidemiology and outcome of invasive fungal infection in adult hematopoietic stem cell transplant recipients: analysis of Multicenter Prospective Antifungal Therapy (PATH) Allianee registry. Clin. Infect. Dis., 48(3):265-273.

[14]Omer, A.K., Ziakas, P.D., Anagnostou, T., et al., 2013. Risk factors for invasive fungal disease after allogeneic hematopoietic stem cell transplantation: a single center experience. Biol. Blood Marrow Transplant., 19(8):1190-1196.

[15]Ozyilmaz, E., Aydogdu, M., Sucak, G., et al., 2010. Risk factors for fungal pulmonary infections in hematopoietic stem cell transplantation recipients: the role of iron overload. Bone Marrow Transplant., 45(10):1528-1533.

[16]Post, M.J., Lass-Floerl, C., Gastl, G., et al., 2007. Invasive fungal infections in allogeneic and autologous stem cell transplant recipients: a single-center study of 166 transplanted patients. Transplant Infect. Dis., 9(3):189-195.

[17]Shi, J.M., Cai, Z., Huang, H., et al., 2009. Role of CT-guided percutaneous lung biopsy in diagnosis of pulmonary fungal infection in patients with hematologic diseases. Int. J. Hematol., 89(5):624-627.

[18]Thursky, K., Byrnes, G., Grigg, A., et al., 2004. Risk factors for post-engraftment invasive aspergillosis in allogeneic stem cell transplantation. Bone Marrow Transplant., 34(2):115-121.

Open peer comments: Debate/Discuss/Question/Opinion

<1>

Please provide your name, email address and a comment





Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2022 Journal of Zhejiang University-SCIENCE