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Incidence and outcome of invasive fungal diseases after allogeneic hematopoietic stem cell transplantation: A Swiss transplant cohort study
Author(s) -
Kuster Sabine,
Stampf Susanne,
Gerber Bernhard,
Baettig Veronika,
Weisser Maja,
Gerull Sabine,
Medinger Michael,
Passweg Jakob,
Schanz Urs,
Garzoni Christian,
Berger Christoph,
Chalandon Yves,
Mueller Nicolas J.,
Delden Christian,
Neofytos Dionysios,
Khanina
Publication year - 2018
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12981
Subject(s) - medicine , incidence (geometry) , hematopoietic stem cell transplantation , cumulative incidence , aspergillosis , transplantation , cohort , epidemiology , immunology , physics , optics
Contemporary, comprehensive data on epidemiology and outcomes of invasive fungal disease ( IFD ) including breakthrough IFD among allogeneic hematopoietic stem cell transplantation ( HSCT ) recipients are scarce. We included 479 allogeneic HSCT recipients with 10 invasive candidiasis ( IC ) and 31 probable/proven invasive mold disease ( IMD ) from the Swiss Transplant Cohort Study from 01.2009 to 08.2013. Overall cumulative incidence was 2.3% for IC and 8.5% for probable/proven IMI : 6% for invasive aspergillosis ( IA ) and 2.5% for non‐ Aspergillus IMI . Among 41 IFD , 46% IFD were breakthrough, with an overall incidence of 4.6%, more frequently caused by other‐than‐ Aspergillus fumigatus molds than primary IFD (47.6% (10/21) vs 13% (3/23), P = 0.04). Twelve‐week mortality among patients with IC was 20% and 58.6% for probable/proven IMD (60% IA and 54.6% non‐ Aspergillus ). Our results reveal that breakthrough IFD represent a marked burden of probable/proven IFD postallogeneic HSCT and mortality remains above 50% in patients with probable/proven IMD , underscoring the ongoing challenges to prevent and treat IFD in these patients.