scholarly journals Underestimating the Real Burden of Invasive Fungal Infections in Hematopoietic Stem Cell Transplant Recipients?

2010 ◽  
Vol 51 (2) ◽  
pp. 253-254 ◽  
Author(s):  
Martin Hoenigl ◽  
Thomas Valentin ◽  
Helmut J. F. Salzer ◽  
Ines Zollner‐Schwetz ◽  
Robert Krause
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Cell Transplant ◽  
Transplant Recipients ◽  
Hematopoietic Stem ◽  
The Real

scholarly journals 1739. Epidemiology of Invasive Fungal Infections in Allogenic Hematopoietic Stem Cell Transplant Recipients in Utah

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S636-S637
Author(s):  
Jessica Zurko ◽  
Brandon J Webb
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
Median Time ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Cell Transplant ◽  
Transplant Recipients ◽  
Hematopoietic Stem

Abstract Background Invasive fungal infections are a leading cause of death in allo-HSCT (allogenic hematopoietic stem cell transplant) recipients. We describe the epidemiology of IFIs (invasive fungal infections) in allo-HSCT recipients at a single institution in Salt Lake City, Utah between 2006 and 2015. Methods We searched all encounters in the Intermountain Healthcare electronic medical record from 2006 to 2015 for clinical data associated with IFIs in allo-HSCT recipients. EORTC-MSG definitions were applied to categorize IFI as proven, probable, or possible. Linear regression was used to model the variation in incidence over time. Results 326 unique allo-HSCT were performed; of these 114 episodes of IFI occurred in 105 patients. Mean incidence was 35.9 IFI per 100 transplants, and increased by 2.3 IFI cases/100 transplants per year. 25.4% of cases were classified as proven; 47.4% as probable and 19.3% as possible. Invasive Aspergillus represented the majority of cases (62.3%), followed by non-specified (in most cases positive imaging and a positive β-d-glucan, 18%), Candidiasis (10%), and Mucorales (3.5%). The median age was 50 years, range 22 to 73, with males representing 52.6% of cases. The most common non-hematologic comorbidities were chronic pulmonary disease (42.9%), chronic heart failure (32.4%), and hepatic disease (31.4%). 48.6% of patients received matched unrelated allo-HSCT, 34.3% received matched sibling donor allo-HSCT, 14.3% received haploidentical allo-HSCT, and 3% received cord allo-HSCT. 79% of transplants were myeloablative. Median time from transplant to onset of IFI was 145 days (95% CI 39–259). The median time to onset of Aspergillosis was 120 days (95% CI 34–241 days), Candidiasis was 130 days (95% CI 12–283 days), and Mucorales was 246 days (95% CI 126–338 days). Active GVHD was present in 60% of IFI cases. 63% of cases were on antifungal prophylaxis, most commonly an echinocandin. All-cause mortality was 30.5% at 42 days and 65.7% at 1 year. The median time to death from the onset of IFI was 68.5 days. Conclusion IFIs are common in allo-HSCT recipients and appear to be increasing in frequency. Further work is needed to risk-stratify patients, determine optimal prophylaxis and empiric treatment, and define resistance trends. Disclosures All authors: No reported disclosures.

scholarly journals RhizomucorandScedosporiumInfection Post Hematopoietic Stem-Cell Transplant

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Dânia Sofia Marques ◽  
Carlos Pinho Vaz ◽  
Rosa Branca ◽  
Fernando Campilho ◽  
Catarina Lamelas ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Unrelated Donor ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Increased Risk

Hematopoietic stem-cell transplant recipients are at increased risk of developing invasive fungal infections. This is a major cause of morbidity and mortality. We report a case of a 17-year-old male patient diagnosed with severe idiopathic acquired aplastic anemia who developed fungal pneumonitis due toRhizomucor sp.and rhinoencephalitis due toScedosporium apiospermum6 and 8 months after undergoing allogeneic hematopoietic stem-cell transplant from an HLA-matched unrelated donor. Discussion highlights risk factors for invasive fungal infections (i.e., mucormycosis and scedosporiosis), its clinical features, and the factors that must be taken into account to successfully treat them (early diagnosis, correction of predisposing factors, aggressive surgical debridement, and antifungal and adjunctive therapies).

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