The Prevalence And Risk Factors Of Invasive Fungal Infection In Patients With Allogeneic Hematopoietic Stem Cell Transplant

Objective: To examine the incidence and risk factors of invasive fungalinfection (IFI) in patients with allogeneic hematopoietic stem celltransplantation (ALLO-HSCT).Methods: The incidence and outcome of IFI after transplantation in twohundred and fifty-three cases of recipients underwent ALLO-HSCT from June2001 to November 2010 were assessed retrospectively. 170 patients were male.83 patients were female. 26 patients were Children. The median age of thepatients was 32 years (range, 1.7 -57years). The distribution of underlinghematological disorders was as follows: acute myeloid leukemia (n=73),acutelymphoblastic leukemia (n=52), chronic myelocytic leukemia (n=70),myelodysplastic syndromes (n=8), aplastic anemia (n=8), multiple myeloma(n=3), non hodgkin lymphoma (n=13),mix acute leukemia (n=3),thalassemia(n=23). Donors were related (n=207), unrelated (n=46). Some potentialinfluential factors for that of IFI were analyzed by methods of Kaplan-Meiersurvival analysis and Cox Regression analysis. Result: The diagnosis of 57 cases of IFI were made, including 2 proven(3.5%), 45 probable(78.9%)and 10 possible cases(17.6%)respectively. The incidence of post-transplantation IFI was 22.5%. IFI related mortality was 63.2%.The survival rate with IFI was 18.0%.The infection occurred a median of 58 days after ALLO-HSCT and the cumulative incidence of IFIs in 6 months after HSCT were 93.0â„….Infective sites in pulmonary or not accounted for were 96.5%and 3.5%.Univariate analysis showed that age, the history of IFI before transplantation, acute GVHD,chronic GVHD and glucocorticosteroid use were important factors affecting the incidence of IFI. Multivariate analysis showed that age, the history of IFI before transplantation, acute GVHD and glucocorticosteroid use were important factors affecting incidence of IFI. .Conclusion:The incidence of post-transplantation IFI was 22.5%. A high proportion of IFI developed between two months and six months after ALLO-HSCT. Pulmonary infection was the most common IFI after ALLO-HSCT. Age, the history of IFI before transplantation, acute GVHD and glucocorticosteroid use were significant risk factors for the incidence of IFI.