Outcome of allogeneic SCT in patients with pre-transplant invasive fungal infection

Salmenniemi, Urpu; Remes, Kari; Itälä‐Remes, Maija

doi:10.1038/bmt.2013.45

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…Previous studies mainly focused on SAP in HSCT recipients [6] , [10] , [11] , [17] , [18] , [21] , [28] , [29] , whereas a fewer studies dealt with patients with chemotherapy [5] , [12] . The present study included patients undergoing chemotherapy or HSCT, a comparison was made among different treatment of underlying disease.…”

Section: Discussionmentioning

confidence: 99%

Secondary Antifungal Prophylaxis in Hematological Malignancy Patients with Previous Invasive Fungal Disease: A Retrospective Analysis

Liu

Zhang

et al. 2014

PLoS ONE

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BackgroundInvasive fungal disease (IFD) causes morbidity and mortality in patients with hematological malignancy. Recurrence of IFD after chemotherapy or hematopoietic stem cell transplantation (HSCT) is associated with poor prognosis. The present study aimed to investigate the efficacy of different strategies of secondary antifungal prophylaxis (SAP) for IFD and choose an appropriate SAP regimen.MethodsClinical data of patients with previous IFD who underwent chemotherapy or HSCT between Jan 2008 and Jun 2013 were retrospectively reviewed and followed up to 180 days post-chemotherapy or HSCT. The clinical characteristics and diagnosis were analyzed according to the diagnostic criteria for IFD. The efficacy of different strategies for SAP and risk factors influencing the failure of SAP were evaluated.ResultsOf the 164 patients enrolled, 121 patients received SAP regimen (73.78%), and IFD recurred in 40 patients: 16.5% (20/121) in SAP group and 46.5% (20/43) in non-SAP group. In SAP group, 58 received SAP agents which were proven effective for their previous IFD, while other 63 patients received other broad-spectrum antifungal agents. There was no significant difference in the recurrence rates between these two subgroups (13.8% (8/58) vs 19.0% (12/63), P = 0.437). The IFD recurrence rates were statistically significant between patients with allogeneic HSCT and chemotherapy or autologous HSCT (25% vs 8.2%, P = 0.013). Multivariate analysis indicated that allogeneic HSCT was the independent risk factor of IFD recurrence after SAP.ConclusionsSecondary antifungal prophylaxis is necessary to prevent IFD recurrence in patients with hematological malignancy, especially for patients in the setting of allogeneic HSCT.

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Section: Discussionmentioning

confidence: 99%

Secondary Antifungal Prophylaxis in Hematological Malignancy Patients with Previous Invasive Fungal Disease: A Retrospective Analysis

Liu

Zhang

et al. 2014

PLoS ONE

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“…Although no standardized strategy for secondary antifungal prophylaxis or optimal timing for performing allo‐SCT has been defined, a prior episode of IFD might be no longer represent a huge barrier for proceeding to allo‐SCT under current options for secondary prophylaxis with new antifungal agents. Moreover, the use of these new drugs would result in comparable transplant outcomes between patients who did and did not undergo SP, implying that SP before allo‐SCT may lack meaning …”

Section: Discussionmentioning

confidence: 99%

Reassessment of clinical implication of pretransplant surgical procedures for pulmonary invasive fungal lesions

Shingai

Kaito

Yamada

et al. 2018

Transplant Infectious Dis

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Dealing with the recent series of allogeneic hematopoietic stem cell transplantation (allo-SCT) performed this decade, we reassessed the clinical impact of pretransplant surgical procedures (SP) for pulmonary lesions of invasive fungal disease (IFD) on subsequent transplant outcome. We focused on the clinical outcomes of seven patients with pulmonary IFD who underwent segmentectomy (n = 4), lobectomy (n = 2) or abscess incision with drainage only (n = 1), and compared results to those of 21 patients carrying pulmonary IFD who never underwent invasive SP before allo-SCT.The rate of exacerbation of pulmonary lesions by 180 days after allo-SCT did not differ significantly between groups (32.2% vs 42.9%, P = 0.69). Moreover, no significant differences in non-relapse mortality (46.4% vs 42.3%, P = 0.93) or overall survival (53.6% vs 30.9%, P = 0.45) at 1 year were evident between groups. These results indicate that pretransplant SP for pulmonary lesions might have no survival benefit under the current antifungal prophylaxis or treatment modality.

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Pulmonary infections in the hematopoietic cell transplant patient

Ford

Crothers

Cheng

2020

Current Opinion in Infectious Diseases

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Purpose of review Despite progress in the management of pulmonary infections in the hematopoietic cell transplant (HCT) population, substantial diagnostic, and therapeutic uncertainty remains. Recent findings A growing HCT population reflects more transplants and improved long-term survival. We continue to learn about the epidemiologic and prognostic significance of posttransplant pulmonary infections. Mold-active triazoles have removed invasive fungal pneumonia as a barrier to transplant eligibility. Ibrutinib and respiratory viruses are newly recognized risk factors for invasive fungal disease. Prophylaxis has elevated concerns of resistance in invasive fungal species and late onset Cytomegalovirus. The impact of human herpesviruses, community-associated respiratory viruses, and the microbiome is increasingly appreciated. Multiple antiviral therapies are currently in clinical trials and novel molecular diagnostics may improve the performance of bronchoscopy for infectious causes. Summary Fungal and viral pneumonias remain an important cause of morbidity and mortality in the HCT population. Despite our increased understanding of the epidemiology and outcomes of species-specific diagnoses, the utility of invasive diagnostic testing continues to be debated and effective therapies for many clinically relevant pathogens remain limited. Pulmonary infections are a priority for research efforts in this immunocompromised population.

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Outcome of allogeneic SCT in patients with pre-transplant invasive fungal infection

Cited by 3 publications

References 4 publications

Secondary Antifungal Prophylaxis in Hematological Malignancy Patients with Previous Invasive Fungal Disease: A Retrospective Analysis

Secondary Antifungal Prophylaxis in Hematological Malignancy Patients with Previous Invasive Fungal Disease: A Retrospective Analysis

Reassessment of clinical implication of pretransplant surgical procedures for pulmonary invasive fungal lesions

Pulmonary infections in the hematopoietic cell transplant patient

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