IR@PKUHSC  > 北京大学第一临床医学院  > 血液内科
学科主题临床医学
Epidemiology, Management, and Outcome of Invasive Fungal Disease in Patients Undergoing Hematopoietic Stem Cell Transplantation in China: A Multicenter Prospective Observational Study
Sun, Yuqian1; Meng, Fanyi2; Han, Mingzhe3,4; Zhang, Xi5; Yu, Li; Huang, He7; Wu, Depei8; Ren, Hanyun9; Wang, Chun10; Shen, Zhixiang11; Ji, Yu1; Huang, Xiaojun1
关键词Allogeneic Autologous China Fungal infection Stem cells Transplant
刊名BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
2015-06-01
DOI10.1016/j.bbmt.2015.03.018
21期:6页:1117-1126
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Hematology ; Immunology ; Transplantation
研究领域[WOS]Hematology ; Immunology ; Transplantation
关键词[WOS]HEMATOLOGICAL MALIGNANCIES ; RISK-FACTORS ; ANTIFUNGAL THERAPY ; MOLD INFECTIONS ; SINGLE-CENTER ; RECIPIENTS ; ASPERGILLOSIS ; RECOMMENDATIONS ; SURVEILLANCE ; GUIDELINE
英文摘要

The China Assessment of Antifungal Therapy in Hematological Disease study, the first large-scale observational study of invasive fungal disease (IFD) in China, enrolled 1401 patients undergoing hematopoietic stem cell transplantation (HSCT) (75.2% allogeneic and 24.8% autologous) at 31 hospitals across China. The overall incidence of proven or probable IFD was 7.7% (108 of 1401); another 266 cases (19.0%) were possible IFD. After allogeneic or autologous HSCT, the incidence of proven/probable IFD was 8.9% (94 of 1053) and 4.0% (14 of 348), respectively. Some cases (14 of 108) developed during conditioning before transplantation. The cumulative incidence of proven/probable IFD increased steeply in the first month after transplantation and after 6 months, the incidence was significantly higher in allogeneic than it was in autologous transplant recipients (9.2% versus 3.5%; P = .001) and when stem cells were derived from cord blood or bone marrow and peripheral blood (P = .02 versus other sources). Independent risk factors for proven/probable IFD in allogeneic HSCT were diabetes, HLA-matched unrelated donor, prolonged severe neutropenia (absolute neutrophil count > 500/mm(3) for >14 days), and immunosuppressants (odds ratio, 2.0 to 3.4 for all). Antifungal prophylaxis Was independently protective (P = .01). Previous IFD and prolonged severe neutropenia were significant independent risk factors among autologous transplantation patients (P<.01, P = .04, respectively). In total, 1175 (83.9%) patients received antifungal prophylaxis (91.6% triazoles) and 514 (36.7%) were treated in the hospital with therapeutic antifungals (89.1% triazoles; median 27 days). Empirical, pre-emptive, and targeted antifungals were used in 82.3%, 13.6%, and 4.1% of cases, respectively. Overall mortality (13.4%; 188 deaths) was markedly higher in patients with proven (5 of 16; 31.3%), probable (20 of 92; 21.7%), or possible (61 of 266; 22.9%) IFD; allogeneic (171 of 1053:16.2%) rather than autologous (17 of 348; 4.9%) HSCT and was significantly higher in patients receiving pre-emptive (18.6%) rather than empirical (6.1%) or targeted (9.5%) antifungal therapy (P = .002). Improvements in the selection and timing of prophylactic antifungals would be welcome. Health care providers should remain alert to the increased risk of IFD and associated mortality in allogeneic HSCT recipients and the ongoing risk of IFD even after discharge from the hospital. (C) 2015 American Society for Blood and Marrow Transplantation.

语种英语
WOS记录号WOS:000354667900020
资助机构Merck Sharp Dohme China
引用统计
被引频次:24[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/61316
专题北京大学第一临床医学院_血液内科
北京大学第二临床医学院_血液科
作者单位1.Peking Univ, Peoples Hosp, Inst Hematol, Beijing Key Lab Hematopoiet Stem Cell Transplanta, Beijing, Peoples R China
2.Nanfang Med Univ, Nanfang Hosp, Guangzhou, Guangdong, Peoples R China
3.Chinese Acad Med Sci, Inst Hematol, Tianjin, Peoples R China
4.Chinese Acad Med Sci, Blood Dis Hosp, Tianjin, Peoples R China
5.Third Mil Med Univ, Affiliated Hosp 2, Xinqiao Hosp, Chongqing, Peoples R China
6.Chinese Peoples Liberat Army Gen Hosp, Hosp 301, Beijing 100853, Peoples R China
7.Zhejiang Univ, Sch Med, Affiliated Hosp 1, Hangzhou 310003, Zhejiang, Peoples R China
8.Soochow Univ, Affiliated Hosp 1, Suzhou, Peoples R China
9.Peking Univ, Hosp 1, Beijing 100871, Peoples R China
10.First Peoples Hosp Shanghai, Shanghai, Peoples R China
11.Shanghai Jiao Tong Univ, Sch Med, Rui Jin Hosp, Shanghai 200030, Peoples R China
推荐引用方式
GB/T 7714
Sun, Yuqian,Meng, Fanyi,Han, Mingzhe,et al. Epidemiology, Management, and Outcome of Invasive Fungal Disease in Patients Undergoing Hematopoietic Stem Cell Transplantation in China: A Multicenter Prospective Observational Study[J]. BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION,2015,21(6):1117-1126.
APA Sun, Yuqian.,Meng, Fanyi.,Han, Mingzhe.,Zhang, Xi.,Yu, Li.,...&Huang, Xiaojun.(2015).Epidemiology, Management, and Outcome of Invasive Fungal Disease in Patients Undergoing Hematopoietic Stem Cell Transplantation in China: A Multicenter Prospective Observational Study.BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION,21(6),1117-1126.
MLA Sun, Yuqian,et al."Epidemiology, Management, and Outcome of Invasive Fungal Disease in Patients Undergoing Hematopoietic Stem Cell Transplantation in China: A Multicenter Prospective Observational Study".BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION 21.6(2015):1117-1126.
条目包含的文件
条目无相关文件。
个性服务
推荐该条目
保存到收藏夹
查看访问统计
导出为Endnote文件
谷歌学术
谷歌学术中相似的文章
[Sun, Yuqian]的文章
[Meng, Fanyi]的文章
[Han, Mingzhe]的文章
百度学术
百度学术中相似的文章
[Sun, Yuqian]的文章
[Meng, Fanyi]的文章
[Han, Mingzhe]的文章
必应学术
必应学术中相似的文章
[Sun, Yuqian]的文章
[Meng, Fanyi]的文章
[Han, Mingzhe]的文章
相关权益政策
暂无数据
收藏/分享
所有评论 (0)
暂无评论
 

除非特别说明,本系统中所有内容都受版权保护,并保留所有权利。