TY - JOUR
T1 - Influence of pre-existing invasive aspergillosis on allo-HSCT outcome
T2 - a retrospective EBMT analysis by the Infectious Diseases and Acute Leukemia Working Parties
AU - Penack, O
AU - Tridello, G
AU - Hoek, J
AU - Socié, G
AU - Blaise, Didier
AU - Passweg, J
AU - Chevallier, P
AU - Craddock, C
AU - Milpied, N
AU - Veelken, H
AU - Maertens, Johan
AU - Ljungman, P
AU - Cornelissen, J
AU - Thiebaut-bertrand, A
AU - Lioure, B
AU - Michallet, M
AU - Iacobelli, S
AU - Nagler, A
AU - Mohty, Mohamad
AU - Cesaro, S
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Historically, invasive aspergillosis (IA) has been a major barrier for allogeneic hematopoietic stem cell transplantation (allo-HSCT). The influence of invasive IA on long-term survival and on transplant-related complications has not been investigated in a larger patient cohort under current conditions. Our aim was to analyze the long-term outcome of patients undergoing allo-HSCT with a history of prior IA. We used European Society for Blood and Marrow Transplantation database data of first allo-HSCTs performed between 2005 and 2010 in patients with acute leukemia. One thousand one hundred and fifty patients with data on IA before allo-HSCT were included in the analysis. The median follow-up time was 52.1 months. We found no significant impact of IA on major transplant outcome variables such as overall survival, relapse-free survival, non-relapse mortality, cumulative incidence of acute GvHD grade II–IV, chronic GvHD, pulmonary complications and leukemia relapse. However, we found a trend toward lower overall survival (P=0.078, hazard ratio (HR) (95% confidence interval (CI)): 1.16 (0.98, 1.36)) and higher non-relapse mortality (P=0.150, HR (95% CI): 1.19 (0.94, 1.50)) in allo-HSCT recipients with pre-existing IA. Our data suggest that a history of IA should not generally be a contraindication when considering the performance of allo-HSCT in patients with acute leukemia.
AB - Historically, invasive aspergillosis (IA) has been a major barrier for allogeneic hematopoietic stem cell transplantation (allo-HSCT). The influence of invasive IA on long-term survival and on transplant-related complications has not been investigated in a larger patient cohort under current conditions. Our aim was to analyze the long-term outcome of patients undergoing allo-HSCT with a history of prior IA. We used European Society for Blood and Marrow Transplantation database data of first allo-HSCTs performed between 2005 and 2010 in patients with acute leukemia. One thousand one hundred and fifty patients with data on IA before allo-HSCT were included in the analysis. The median follow-up time was 52.1 months. We found no significant impact of IA on major transplant outcome variables such as overall survival, relapse-free survival, non-relapse mortality, cumulative incidence of acute GvHD grade II–IV, chronic GvHD, pulmonary complications and leukemia relapse. However, we found a trend toward lower overall survival (P=0.078, hazard ratio (HR) (95% confidence interval (CI)): 1.16 (0.98, 1.36)) and higher non-relapse mortality (P=0.150, HR (95% CI): 1.19 (0.94, 1.50)) in allo-HSCT recipients with pre-existing IA. Our data suggest that a history of IA should not generally be a contraindication when considering the performance of allo-HSCT in patients with acute leukemia.
U2 - 10.1038/bmt.2015.237
DO - 10.1038/bmt.2015.237
M3 - Article
SN - 0268-3369
VL - 51
SP - 418
EP - 423
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 3
ER -
