Invasive Fungal Infection in Hematopoietic Stem Cell Transplant Recipient from an Indian Oncology Setting

Author:

Ghafur Abdul1,Das Bikram1,Raja T2,Easow Jose2,Kartikeyan Radhika1,Easow Benjamin M.1,Ramanan S G.2

Affiliation:

1. Department of Infectious Diseases, Apollo Cancer Institute, Chennai, Tamil Nadu, India

2. Department of Oncology, Apollo Cancer Institute, Chennai, Tamil Nadu, India

Abstract

Objective Invasive fungal infections (IFI) are one of the major causes of morbidity and mortality in post-hematopoietic stem cell transplant (HSCT) recipients. Data from India is limited. The objective of this study was to analyze the incidence, risk factors, and outcomes associated with IFI in our center. Materials and Methods Adult patients, who underwent marrow/stem cell transplantation between 2014 and 2018, in an oncology center in India, were included in this single-center retrospective observational study. The revised European Organization for Research and Treatment of Cancer/ Mycoses Study Group (EORTC/MSG) consensus group 2008 definition for IFI was considered to define cases. Incidence, risk factors, and outcomes associated with IFI were analyzed. Statistical Analysis All continuous variables were represented by mean ± standard deviation and categorical variables as percentage. Comparison of categorical variables was done by either the chi-squared test or Fisher's exact test. All “p” values less than 0.05 were considered statistically significant. Results Out of the 126 patients who underwent HSCT between January 2014 and December 2018, 56 (44.4%) patients had allo-HSCT, 64 (50.8%) had auto-HSCT, and 6 (4.8%) had haplo-identical HSCT. Eighty-three (63%) patients were male and 43 (34%) females, and 113 (83.9%) Asians and 13 (10.3%) Africans. Total 111 (88%) patients received myeloablative conditioning and 24 (19%) received total body irradiation. The hematological conditions were acute myeloid leukemia (n = 23; 18.25%), acute lymphoblastic leukemia (n = 16; 12.69%), chronic myeloid leukemia (n = 4; 3.17%), Hodgkin lymphoma (n = 17; 13.4%), non-Hodgkin lymphoma (n = 11; 8.73%), myeloma (n = 35; 27.7%), sickle cell disease (n = 13; 10.31%), etc. Most patients received fluconazole (78; 61.9%) followed by micafungin (23; 18.25%), posaconazole (20; 15.87%), voriconazole (4; 3.17%), and liposomal amphotericin B (1; 0.79%) as antifungal prophylaxis. The overall rate of IFI (possible cases included) was auto-HSCT (n = 5; 7.81%), and allo-HSCT (n = 5; 8.92%). Among auto-HSCT, the IFI was proven = 0, probable n = 1 (1.5%), and possible n = 4 (6.25%) and among allo-HSCT the IFI was proven = 0, probable n = 2 (3.57%), and possible n = 3 (5.35%). No patients in haplo-HSCT had IFI. The 1-year survival rate among the IFI cases was 8/10(80%). A meaningful comparison of the risk factors and the impact of prophylactic regimens were difficult because of the very low number of IFI cases. Conclusions The overall rate of IFI in HSCT patients in our setting was low compared to global data on IFI in HSCT.

Funder

Cipla pharmaceuticals, as an investigator-initiated study.

Publisher

Georg Thieme Verlag KG

Subject

Cancer Research,Oncology

Reference17 articles.

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3