Loading…
Invasive fungal disease in allogeneic hematopoietic stem cell transplant recipients: an autopsy-driven survey
: Invasive mycoses are pre‐eminent causes of morbidity and mortality in the allogeneic stem cell transplant setting. In spite of novel diagnostic modalities, the timely and specific identification of invasive mycoses still remains challenging. We analyzed the case history of 97 consecutive patients...
Saved in:
| Published in: | Transplant infectious disease 2008-04, Vol.10 (2), p.106-109 |
|---|---|
| Main Authors: | , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c4704-bc66b19ff1824304e912a61efa2d8d9bd3f4734446129f1c22c86fbe9e591e2c3 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c4704-bc66b19ff1824304e912a61efa2d8d9bd3f4734446129f1c22c86fbe9e591e2c3 |
| container_end_page | 109 |
| container_issue | 2 |
| container_start_page | 106 |
| container_title | Transplant infectious disease |
| container_volume | 10 |
| creator | Sinkó, J. Csomor, J. Nikolova, R. Lueff, S. Kriván, G. Reményi, P. Bátai, Á. Masszi, T. |
| description | : Invasive mycoses are pre‐eminent causes of morbidity and mortality in the allogeneic stem cell transplant setting. In spite of novel diagnostic modalities, the timely and specific identification of invasive mycoses still remains challenging. We analyzed the case history of 97 consecutive patients receiving 103 allogeneic stem cell transplants between January 2003 and October 2006 performed by a single team at 2 transplant centers in Budapest, Hungary. All patients with febrile neutropenia not responding to broad‐spectrum antibacterial therapy received amphotericin B deoxycholate empirically. In cases of proven or probable invasive aspergillosis, intravenous voriconazole was instituted. Patients who failed to improve on initial therapy were treated with an antifungal combination, while responders were switched to oral voriconazole. A total of 38 patients died following allografting. Both centers had an autopsy rate of 100% due to central health care regulations. An infectious cause of death could be identified in 15 cases, invasive fungal disease being the most prevalent and accounting for 10 fatalities. Six patients died of invasive aspergillosis, while invasive candidiasis and mucormycosis led to a fatal outcome in 2 cases each. Despite the regular use of galactomannan antigen detections and imaging, an ante mortem diagnosis of proven/probable invasive fungal disease could only be established in 4 of 10 autopsy‐verified cases (aspergillosis: 3, candidiasis: 1, mucormycosis: 0). In the remaining 6 patients, deep mycoses were missed clinically and were revealed only by postmortem histology. Present diagnostic and therapeutic strategies still seem to be suboptimal for the management of invasive fungal diseases in the high‐risk allogeneic stem cell transplant population. |
| doi_str_mv | 10.1111/j.1399-3062.2007.00264.x |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68092550</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>68092550</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4704-bc66b19ff1824304e912a61efa2d8d9bd3f4734446129f1c22c86fbe9e591e2c3</originalsourceid><addsrcrecordid>eNqNkM1u1DAURiMEoqXwCsgrdgn-ix0jNqgtZVBVhBiExMZykuviIXFSOxlm3h6nM2q39cbX8nc-WyfLEMEFSev9piBMqZxhQQuKsSwwpoIXu2fZ6cPF8_u5yimV7CR7FeMGYyIVVy-zEyIFLiWVp1m_8lsT3RaQnf2t6VDrIpgIyHlkum64BQ-uQX-gN9MwDg6mdIoT9KiBrkNTMD6OnfETCtC40YGf4gdkEjynfNznbUjlHsU5bGH_OnthTRfhzXE_y35-vlyff8mvv12tzj9d5w2XmOd1I0RNlLWkopxhDopQIwhYQ9uqVXXLLJeMcy4IVZY0lDaVsDUoKBUB2rCz7N2hdwzD3Qxx0r2Ly4eNh2GOWlRY0bLEKVgdgk0YYgxg9Rhcb8JeE6wX1XqjF6N6MaoX1fpetd4l9O3xjbnuoX0Ej25T4OMh8M91sH9ysV6vLtKQ8PyAu6R794Cb8FcLyWSpf91c6d8_-A39uv6uK_YfNPueLw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>68092550</pqid></control><display><type>article</type><title>Invasive fungal disease in allogeneic hematopoietic stem cell transplant recipients: an autopsy-driven survey</title><source>Wiley</source><creator>Sinkó, J. ; Csomor, J. ; Nikolova, R. ; Lueff, S. ; Kriván, G. ; Reményi, P. ; Bátai, Á. ; Masszi, T.</creator><creatorcontrib>Sinkó, J. ; Csomor, J. ; Nikolova, R. ; Lueff, S. ; Kriván, G. ; Reményi, P. ; Bátai, Á. ; Masszi, T.</creatorcontrib><description>: Invasive mycoses are pre‐eminent causes of morbidity and mortality in the allogeneic stem cell transplant setting. In spite of novel diagnostic modalities, the timely and specific identification of invasive mycoses still remains challenging. We analyzed the case history of 97 consecutive patients receiving 103 allogeneic stem cell transplants between January 2003 and October 2006 performed by a single team at 2 transplant centers in Budapest, Hungary. All patients with febrile neutropenia not responding to broad‐spectrum antibacterial therapy received amphotericin B deoxycholate empirically. In cases of proven or probable invasive aspergillosis, intravenous voriconazole was instituted. Patients who failed to improve on initial therapy were treated with an antifungal combination, while responders were switched to oral voriconazole. A total of 38 patients died following allografting. Both centers had an autopsy rate of 100% due to central health care regulations. An infectious cause of death could be identified in 15 cases, invasive fungal disease being the most prevalent and accounting for 10 fatalities. Six patients died of invasive aspergillosis, while invasive candidiasis and mucormycosis led to a fatal outcome in 2 cases each. Despite the regular use of galactomannan antigen detections and imaging, an ante mortem diagnosis of proven/probable invasive fungal disease could only be established in 4 of 10 autopsy‐verified cases (aspergillosis: 3, candidiasis: 1, mucormycosis: 0). In the remaining 6 patients, deep mycoses were missed clinically and were revealed only by postmortem histology. Present diagnostic and therapeutic strategies still seem to be suboptimal for the management of invasive fungal diseases in the high‐risk allogeneic stem cell transplant population.</description><identifier>ISSN: 1398-2273</identifier><identifier>EISSN: 1399-3062</identifier><identifier>DOI: 10.1111/j.1399-3062.2007.00264.x</identifier><identifier>PMID: 17605727</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>Administration, Oral ; Adolescent ; Adult ; Antifungal Agents - administration & dosage ; Antifungal Agents - therapeutic use ; aspergillosis ; Aspergillosis - diagnosis ; Aspergillosis - drug therapy ; Aspergillosis - mortality ; Autopsy ; candidiasis ; Candidiasis - diagnosis ; Candidiasis - drug therapy ; Candidiasis - mortality ; Child ; Child, Preschool ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Infant ; Injections, Intravenous ; invasive mycosis ; Male ; Middle Aged ; mucormycosis ; Mycoses - diagnosis ; Mycoses - drug therapy ; Mycoses - mortality ; preemptive therapy ; Transplantation, Homologous ; Treatment Outcome</subject><ispartof>Transplant infectious disease, 2008-04, Vol.10 (2), p.106-109</ispartof><rights>Copyright © Blackwell Munksgaard 2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4704-bc66b19ff1824304e912a61efa2d8d9bd3f4734446129f1c22c86fbe9e591e2c3</citedby><cites>FETCH-LOGICAL-c4704-bc66b19ff1824304e912a61efa2d8d9bd3f4734446129f1c22c86fbe9e591e2c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1399-3062.2007.00264.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1399-3062.2007.00264.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,786,790,27957,27958,50923,51032</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17605727$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sinkó, J.</creatorcontrib><creatorcontrib>Csomor, J.</creatorcontrib><creatorcontrib>Nikolova, R.</creatorcontrib><creatorcontrib>Lueff, S.</creatorcontrib><creatorcontrib>Kriván, G.</creatorcontrib><creatorcontrib>Reményi, P.</creatorcontrib><creatorcontrib>Bátai, Á.</creatorcontrib><creatorcontrib>Masszi, T.</creatorcontrib><title>Invasive fungal disease in allogeneic hematopoietic stem cell transplant recipients: an autopsy-driven survey</title><title>Transplant infectious disease</title><addtitle>Transpl Infect Dis</addtitle><description>: Invasive mycoses are pre‐eminent causes of morbidity and mortality in the allogeneic stem cell transplant setting. In spite of novel diagnostic modalities, the timely and specific identification of invasive mycoses still remains challenging. We analyzed the case history of 97 consecutive patients receiving 103 allogeneic stem cell transplants between January 2003 and October 2006 performed by a single team at 2 transplant centers in Budapest, Hungary. All patients with febrile neutropenia not responding to broad‐spectrum antibacterial therapy received amphotericin B deoxycholate empirically. In cases of proven or probable invasive aspergillosis, intravenous voriconazole was instituted. Patients who failed to improve on initial therapy were treated with an antifungal combination, while responders were switched to oral voriconazole. A total of 38 patients died following allografting. Both centers had an autopsy rate of 100% due to central health care regulations. An infectious cause of death could be identified in 15 cases, invasive fungal disease being the most prevalent and accounting for 10 fatalities. Six patients died of invasive aspergillosis, while invasive candidiasis and mucormycosis led to a fatal outcome in 2 cases each. Despite the regular use of galactomannan antigen detections and imaging, an ante mortem diagnosis of proven/probable invasive fungal disease could only be established in 4 of 10 autopsy‐verified cases (aspergillosis: 3, candidiasis: 1, mucormycosis: 0). In the remaining 6 patients, deep mycoses were missed clinically and were revealed only by postmortem histology. Present diagnostic and therapeutic strategies still seem to be suboptimal for the management of invasive fungal diseases in the high‐risk allogeneic stem cell transplant population.</description><subject>Administration, Oral</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Antifungal Agents - administration & dosage</subject><subject>Antifungal Agents - therapeutic use</subject><subject>aspergillosis</subject><subject>Aspergillosis - diagnosis</subject><subject>Aspergillosis - drug therapy</subject><subject>Aspergillosis - mortality</subject><subject>Autopsy</subject><subject>candidiasis</subject><subject>Candidiasis - diagnosis</subject><subject>Candidiasis - drug therapy</subject><subject>Candidiasis - mortality</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Humans</subject><subject>Infant</subject><subject>Injections, Intravenous</subject><subject>invasive mycosis</subject><subject>Male</subject><subject>Middle Aged</subject><subject>mucormycosis</subject><subject>Mycoses - diagnosis</subject><subject>Mycoses - drug therapy</subject><subject>Mycoses - mortality</subject><subject>preemptive therapy</subject><subject>Transplantation, Homologous</subject><subject>Treatment Outcome</subject><issn>1398-2273</issn><issn>1399-3062</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><recordid>eNqNkM1u1DAURiMEoqXwCsgrdgn-ix0jNqgtZVBVhBiExMZykuviIXFSOxlm3h6nM2q39cbX8nc-WyfLEMEFSev9piBMqZxhQQuKsSwwpoIXu2fZ6cPF8_u5yimV7CR7FeMGYyIVVy-zEyIFLiWVp1m_8lsT3RaQnf2t6VDrIpgIyHlkum64BQ-uQX-gN9MwDg6mdIoT9KiBrkNTMD6OnfETCtC40YGf4gdkEjynfNznbUjlHsU5bGH_OnthTRfhzXE_y35-vlyff8mvv12tzj9d5w2XmOd1I0RNlLWkopxhDopQIwhYQ9uqVXXLLJeMcy4IVZY0lDaVsDUoKBUB2rCz7N2hdwzD3Qxx0r2Ly4eNh2GOWlRY0bLEKVgdgk0YYgxg9Rhcb8JeE6wX1XqjF6N6MaoX1fpetd4l9O3xjbnuoX0Ej25T4OMh8M91sH9ysV6vLtKQ8PyAu6R794Cb8FcLyWSpf91c6d8_-A39uv6uK_YfNPueLw</recordid><startdate>200804</startdate><enddate>200804</enddate><creator>Sinkó, J.</creator><creator>Csomor, J.</creator><creator>Nikolova, R.</creator><creator>Lueff, S.</creator><creator>Kriván, G.</creator><creator>Reményi, P.</creator><creator>Bátai, Á.</creator><creator>Masszi, T.</creator><general>Blackwell Publishing Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200804</creationdate><title>Invasive fungal disease in allogeneic hematopoietic stem cell transplant recipients: an autopsy-driven survey</title><author>Sinkó, J. ; Csomor, J. ; Nikolova, R. ; Lueff, S. ; Kriván, G. ; Reményi, P. ; Bátai, Á. ; Masszi, T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4704-bc66b19ff1824304e912a61efa2d8d9bd3f4734446129f1c22c86fbe9e591e2c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Administration, Oral</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Antifungal Agents - administration & dosage</topic><topic>Antifungal Agents - therapeutic use</topic><topic>aspergillosis</topic><topic>Aspergillosis - diagnosis</topic><topic>Aspergillosis - drug therapy</topic><topic>Aspergillosis - mortality</topic><topic>Autopsy</topic><topic>candidiasis</topic><topic>Candidiasis - diagnosis</topic><topic>Candidiasis - drug therapy</topic><topic>Candidiasis - mortality</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Humans</topic><topic>Infant</topic><topic>Injections, Intravenous</topic><topic>invasive mycosis</topic><topic>Male</topic><topic>Middle Aged</topic><topic>mucormycosis</topic><topic>Mycoses - diagnosis</topic><topic>Mycoses - drug therapy</topic><topic>Mycoses - mortality</topic><topic>preemptive therapy</topic><topic>Transplantation, Homologous</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sinkó, J.</creatorcontrib><creatorcontrib>Csomor, J.</creatorcontrib><creatorcontrib>Nikolova, R.</creatorcontrib><creatorcontrib>Lueff, S.</creatorcontrib><creatorcontrib>Kriván, G.</creatorcontrib><creatorcontrib>Reményi, P.</creatorcontrib><creatorcontrib>Bátai, Á.</creatorcontrib><creatorcontrib>Masszi, T.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transplant infectious disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sinkó, J.</au><au>Csomor, J.</au><au>Nikolova, R.</au><au>Lueff, S.</au><au>Kriván, G.</au><au>Reményi, P.</au><au>Bátai, Á.</au><au>Masszi, T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Invasive fungal disease in allogeneic hematopoietic stem cell transplant recipients: an autopsy-driven survey</atitle><jtitle>Transplant infectious disease</jtitle><addtitle>Transpl Infect Dis</addtitle><date>2008-04</date><risdate>2008</risdate><volume>10</volume><issue>2</issue><spage>106</spage><epage>109</epage><pages>106-109</pages><issn>1398-2273</issn><eissn>1399-3062</eissn><notes>ark:/67375/WNG-ZS4N2JTQ-8</notes><notes>ArticleID:TID264</notes><notes>istex:4E957AAC6859694448ED56D7C287A0345E0342A6</notes><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>: Invasive mycoses are pre‐eminent causes of morbidity and mortality in the allogeneic stem cell transplant setting. In spite of novel diagnostic modalities, the timely and specific identification of invasive mycoses still remains challenging. We analyzed the case history of 97 consecutive patients receiving 103 allogeneic stem cell transplants between January 2003 and October 2006 performed by a single team at 2 transplant centers in Budapest, Hungary. All patients with febrile neutropenia not responding to broad‐spectrum antibacterial therapy received amphotericin B deoxycholate empirically. In cases of proven or probable invasive aspergillosis, intravenous voriconazole was instituted. Patients who failed to improve on initial therapy were treated with an antifungal combination, while responders were switched to oral voriconazole. A total of 38 patients died following allografting. Both centers had an autopsy rate of 100% due to central health care regulations. An infectious cause of death could be identified in 15 cases, invasive fungal disease being the most prevalent and accounting for 10 fatalities. Six patients died of invasive aspergillosis, while invasive candidiasis and mucormycosis led to a fatal outcome in 2 cases each. Despite the regular use of galactomannan antigen detections and imaging, an ante mortem diagnosis of proven/probable invasive fungal disease could only be established in 4 of 10 autopsy‐verified cases (aspergillosis: 3, candidiasis: 1, mucormycosis: 0). In the remaining 6 patients, deep mycoses were missed clinically and were revealed only by postmortem histology. Present diagnostic and therapeutic strategies still seem to be suboptimal for the management of invasive fungal diseases in the high‐risk allogeneic stem cell transplant population.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>17605727</pmid><doi>10.1111/j.1399-3062.2007.00264.x</doi><tpages>4</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1398-2273 |
| ispartof | Transplant infectious disease, 2008-04, Vol.10 (2), p.106-109 |
| issn | 1398-2273 1399-3062 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_68092550 |
| source | Wiley |
| subjects | Administration, Oral Adolescent Adult Antifungal Agents - administration & dosage Antifungal Agents - therapeutic use aspergillosis Aspergillosis - diagnosis Aspergillosis - drug therapy Aspergillosis - mortality Autopsy candidiasis Candidiasis - diagnosis Candidiasis - drug therapy Candidiasis - mortality Child Child, Preschool Female Hematopoietic Stem Cell Transplantation Humans Infant Injections, Intravenous invasive mycosis Male Middle Aged mucormycosis Mycoses - diagnosis Mycoses - drug therapy Mycoses - mortality preemptive therapy Transplantation, Homologous Treatment Outcome |
| title | Invasive fungal disease in allogeneic hematopoietic stem cell transplant recipients: an autopsy-driven survey |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-09-21T10%3A40%3A35IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Invasive%20fungal%20disease%20in%20allogeneic%20hematopoietic%20stem%20cell%20transplant%20recipients:%20an%20autopsy-driven%20survey&rft.jtitle=Transplant%20infectious%20disease&rft.au=Sink%C3%B3,%20J.&rft.date=2008-04&rft.volume=10&rft.issue=2&rft.spage=106&rft.epage=109&rft.pages=106-109&rft.issn=1398-2273&rft.eissn=1399-3062&rft_id=info:doi/10.1111/j.1399-3062.2007.00264.x&rft_dat=%3Cproquest_cross%3E68092550%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c4704-bc66b19ff1824304e912a61efa2d8d9bd3f4734446129f1c22c86fbe9e591e2c3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=68092550&rft_id=info:pmid/17605727&rfr_iscdi=true |