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Invasive fungal infections in autologous stem cell transplant recipients: a nation‐wide study of 1188 transplanted patients
Author(s) -
Jantunen E.,
Salonen J.,
Juvonen E.,
Koivunen E.,
Siitonen T.,
Lehtinen T.,
Kuittinen O.,
Leppä S.,
Anttila VJ.,
Itälä M.,
Wiklund T.,
Remes K.,
Nousiainen T.
Publication year - 2004
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2004.00273.x
Subject(s) - medicine , aspergillosis , incidence (geometry) , lymphoma , multiple myeloma , epidemiology , cd34 , autologous stem cell transplantation , cumulative incidence , gastroenterology , mycosis fungoides , transplantation , oncology , stem cell , immunology , biology , physics , optics , genetics
Based on small single‐centre series, the risk of invasive fungal infections (IFI) has been considered small in autologous stem cell transplant (ASCT) recipients. Purpose : To analyse epidemiological and clinical features of (IFI) among ASCT recipients in Finland 1990–2001. Patients : During the study period, 1188 adult patients received high‐dose therapy supported by ASCT in six centres. Altogether, 1112 patients (94%) received blood progenitor cells. The graft was CD34+ selected in 261 patients (22%). The major diagnostic groups were non‐Hodgkin's lymphoma ( n = 417), multiple myeloma ( n = 395), breast cancer ( n = 132) and Hodgkin's lymphoma ( n = 53). Results : Eighteen patients (1.5%) with IFI were identified. The incidence of proven or probable invasive aspergillosis was 0.8%, followed by candidaemia with an incidence of 0.3%. The median time to the diagnosis of IFI was 35 d (6–162) from the progenitor cell infusion. In fourteen patients (78%) IFI was diagnosed during lifetime and they were treated with antifungal therapy for a median of 50 d. Nine patients (64%) were cured. Conclusions : IFI appears to be a rare event after ASCT and Aspergillus infections seem to be predominant. These epidemiological features have an impact in planning prophylactic and empirical antifungal strategies in ASCT recipients.