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Invasive fungal disease in patients undergoing umbilical cord blood transplantation after myeloablative conditioning regimen

2018; Wiley; Volume: 102; Issue: 4 Linguagem: Inglês

10.1111/ejh.13202

1600-0609

Juan Montoro, Jaime Sanz, José Ignacio Lorenzo, Pau Montesinos, Rebeca Rodríguez‐Veiga, Miguel Salavert, Eva González, Manuel Guerreiro, Carlos Carretero, Aitana Balaguer‐Roselló, Inés Gómez‐Seguí, Pilar Solves, Guillermo Sanz, Miguel Á. Sanz, José Luís Piñana,

Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis

Characteristics and risk factors (RFs) of invasive fungal disease (IFD) have been little studied in the setting of umbilical cord blood transplantation (UCBT).We retrospectively included 205 single-unit myeloablative UCBT recipients with a median follow-up of 64 months.Fifty-six episodes of IFD were observed in 48 patients (23%) at a median time of 123 days after stem cell infusion. Invasive mold disease (IMD) occurred in 42 cases, 38 of them (90%) caused by invasive aspergillosis whereas invasive yeast disease (IYD) occurred in 14 cases, most of them due to candidemia (n = 12, 86%). The 5-year cumulative incidence of IFD, IMDs, and IYDs was 24% 19%, and 7%, respectively. In multivariate analysis, three RFs for IMDs were identified: age >30 years (HR 3.5, P = 0.017), acute grade II-IV graft-versus-host disease (HR 2.3, P = 0.011), and ≥1 previous transplant (HR 3.1, P = 0.012). The probability of IMDs was 2.5%, 14%, and 33% for recipients with none, 1, or 2-3 RFs, respectively (P < 0.001). Among IFD, IMDs had a negative effect on non-relapse mortality in multivariate analysis (HR 1.6, P = 0.039). IMDs showed a negative impact on overall survival (HR 1.59, P = 0.018).Invasive mold disease were very common and serious complication after UCBT.