Open AccessPS1283 CLINICAL IMPLICATIONS OF AZOLE‐RESISTANT VERSUS AZOLE‐SUSCEPTIBLE INVASIVE ASPERGILLOSIS IN HEMATOLOGICAL MALIGNANCY (CLARITY) – A MULTICENTER STUDY
Author(s) -
Cornely O.A.,
Seidel D.,
Arenz D.,
Meis J.F.,
Vehreschild J.J. V.,
Racil Z.,
Blennow O.,
Lagrou K.,
Maertens J.,
Sharpe A. Reséndiz,
LassFlörl C.,
Le Govic Y.,
Ostojic A.,
Melchers W.J.,
Vehreschild M.J.,
Verweij P.E.
Publication year - 2019
Publication title -
hemasphere
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 11
ISSN - 2572-9241
DOI - 10.1097/01.hs9.0000563412.43453.c7
Subject(s) - nivolumab , medicine , salvage therapy , aspergillosis , fluconazole , immunotherapy , immunology , chemotherapy , cancer , dermatology , antifungal
Background: In recent years, survival of patients with invasive aspergillosis (IA) has improved mainly due to availability of azoles. These advances are jeopardized by the emergence of azole resistance in Aspergillus fumigatus , the most common causative pathogen of IA. Despite several studies suggesting high probability of azole treatment failure in patients with azole‐resistant isolates, the clinical implications of azole‐resistant IA compared to azole‐susceptible IA remain unclear. Aims: To determine the efficacy of antifungal therapy in patients with documented azole‐resistant IA compared to azole‐sensitive IA in patients with hematological malignancy. Methods: Retrospective data of patients with hematological malignancy with proven or probable IA caused by Aspergillus fumigatus are documented via an electronic case report form ( www.clinicalsurveys.net ), comprising demographics, diagnosis, treatment, response and outcome. Participating sites provided susceptibility results or isolates. Results: Since January 2018, 44 sites enrolled 117 cases from 13 countries worldwide, of which 17 (14.5%) were azole‐resistant. A mixed fungal infection was reported for 31 patients (26.5%), 1 (5.9%) in the azole‐resistant group, 30 (30%) in the azole‐susceptible group. Seventy‐four patients (63.2%) were male, 14 (82.4%) in the azole‐resistant group, 60 (60%) in the azole‐susceptible group. Median age was between 50–69 years in both groups (ranging from 1–12 months to 70–89 years for azole‐resistant cases, 1–6 years to 70–89 years for azole‐susceptible cases). Underlying disease and survival are shown in table. In 20 countries, 55 additional sites screen patients currently. Summary/Conclusion: A worldwide network of investigators contributes to the CLARITY registry study. Completion of recruitment and subsequent data analysis are planned for 2019. Further sites may be added.