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Invasive aspergillosis before allogeneic hematopoietic stem cell transplantation: 10-year experience at a single transplant center  Takahiro Fukuda, Michael.

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Presentation on theme: "Invasive aspergillosis before allogeneic hematopoietic stem cell transplantation: 10-year experience at a single transplant center  Takahiro Fukuda, Michael."— Presentation transcript:

1 Invasive aspergillosis before allogeneic hematopoietic stem cell transplantation: 10-year experience at a single transplant center  Takahiro Fukuda, Michael Boeckh, Katherine A Guthrie, Debra K Mattson, Stephanie Owens, Anna Wald, Brenda M Sandmaier, Lawrence Corey, Rainer F Storb, Kieren A Marr  Biology of Blood and Marrow Transplantation  Volume 10, Issue 7, Pages (July 2004) DOI: /j.bbmt

2 Figure 1 Cumulative incidence of invasive aspergillosis (IA), overall survival (OS), and transplant-related mortality (TRM) among allogeneic HCT recipients with or without histories of IA. A, The cumulative incidence of proven or probable IA was significantly higher among patients with histories of IA (broken line; n = 45) as compared with those without prior IA (solid line; n = 2274; 22% versus 7% at day 100; 29% versus 10% at 1 year; P = .001). B, The OS of patients with histories of IA (broken line; n = 45) was significantly worse as compared with those without prior IA (solid line; n = 2274; 56% versus 77% at day 100; 37% versus 58% at 1 year; P = .001). C, The probability of TRM among patients with histories of IA (broken line; n = 45) was significantly higher as compared with those without prior IA (solid line; n = 2274; 38% versus 21% at day 100; 54% versus 32% at 1 year; P = .001). Biology of Blood and Marrow Transplantation  , DOI: ( /j.bbmt )

3 Figure 2 Invasive aspergillosis (IA) after allogeneic HCT among patients with histories of IA. A, The cumulative incidence of proven or probable IA was significantly higher among patients with histories of IA who received pretransplantation antifungal therapy (Rx) for ≤30 days (broken line; n = 6) as compared with >30 days (solid line; n = 39; 67% versus 15% at day 100; P = .001). B, Among patients with histories of IA that involved the lungs, the cumulative incidence of proven or probable IA was somewhat higher in patients whose pretransplantation chest x-ray (CXR) was abnormal (broken line; n = 19) as compared to those with normal CXR (solid line; n = 16; 32% versus 7% at day 100; P = .064). Biology of Blood and Marrow Transplantation  , DOI: ( /j.bbmt )

4 Figure 3 Transplant-related mortality (TRM) after allogeneic HCT among patients with histories of IA. A, The probability of TRM was significantly higher among patients with histories of IA who received pretransplantation antifungal therapy (Rx) for ≤30 days (broken line; n = 6) compared with >30 days (solid line; n = 39; 67% versus 36% at day 100; P = .033). B, The probability of TRM was significantly higher among patients with histories of IA who received high-dose (HD) TBI-based conventional conditioning (solid line; n = 31) as compared with those who received non—TBI-based conventional or nonmyeloablative conditioning (broken line; n = 14; 52% versus 14% at day 100; P = .024). Biology of Blood and Marrow Transplantation  , DOI: ( /j.bbmt )

5 Figure 4 Cumulative incidence of invasive aspergillosis (IA) and overall survival (OS) after allogeneic HCT. Patients with prior IA who were at high risk (defined by pretransplantation antifungal therapy for ≤30 days or abnormal chest x-ray; broken line; n = 22) had a significantly higher incidence of posttransplantation IA (A) and lower survival (B) at 1 year after HCT as compared with those without prior IA (solid line; n = 2274; 45% versus 10%, P = .001; and 23% versus 58%, P = .001, respectively). However, the cumulative incidence of posttransplantation IA (A) and survival (B) among patients with prior IA who were at low risk (defined by pretransplantation antifungal therapy for >30 days and normal chest x-ray; dotted line; n = 23) were not statistically different from those among patients without prior IA (solid line; n = 2274; 13% versus 10%, P = .65; and 52% versus 58%, P = .47, respectively). Biology of Blood and Marrow Transplantation  , DOI: ( /j.bbmt )


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