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Cytology

Incidence of Invasive Aspergillosis After Reduced-Intensity Stem Cell Transplantation

Strategic Insights

— 2 min read

Allogeneic stem cell transplantation, either with reduced intensity or conventional therapy, poses a significant risk of invasive aspergillosis (IA). A study from Japan analyzed the clinical characteristics of IA after reduced-intensity stem cell transplantation (RIST) compared with conventional stem cell transplantation (CST). The findings indicate that IA occurs later following RIST than CST, and mortality rates remain high despite the difference in incidence.

Key Takeaways:

  • The overall incidence of IA after allogeneic transplantation was 35 (5.3%) of 664, with a 3-year cumulative incidence of 5.6%.
  • The estimated 3-year incidence of IA in CST was 4.5%, while in RIST it was 8.2% (P=0.045).
  • The median onset of IA after RIST occurred significantly later than that after CST, at day 127 versus day 97.
  • Multivariate analysis revealed that IA was associated with age older than 50 years (relative risk, 2.12; 95% confidence interval, 1.08-4.17; P=0.03) and the presence of acute and/or chronic GVHD (relative risk, 6.2; 95% confidence interval, 2.4-16.4; P=0.0002).
  • The mortality rates for IA after CST and RIST were 76% and 86%, respectively.
  • Kojima and colleagues published their research in the journal Biology of Blood and Marrow Transplantation, highlighting the need for further research into the prevention and treatment of IA after allogeneic transplantation.
  • The study emphasizes the importance of monitoring and managing patients at risk for IA, particularly those with advanced age and a history of acute and/or chronic GVHD.

Statistics:

  • Overall incidence of IA after allogeneic transplantation: 35 (5.3%) of 664
  • 3-year cumulative incidence of IA: 5.6%
  • Estimated 3-year incidence of IA in CST: 4.5%
  • Estimated 3-year incidence of IA in RIST: 8.2% (P=0.045)
  • Median onset of IA after RIST: day 127
  • Median onset of IA after CST: day 97
  • Relative risk of IA with age older than 50 years: 2.12 (95% confidence interval, 1.08-4.17; P=0.03)
  • Relative risk of IA with acute and/or chronic GVHD: 6.2 (95% confidence interval, 2.4-16.4; P=0.0002)

Sources:

  • Kojima et al. (2004). Incidence of invasive aspergillosis after allogeneic hematopoietic stem cell transplantation with a reduced-intensity regimen compared with transplantation with a conventional regimen. Biology of Blood and Marrow Transplantation, 10(9), 645-652.
  • Kami M, National Cancer Center, Hematopoietic Stem cell Transplantation Unit, Chuo Ku, 1-1 Tsukiji 5 chome, Tokyo 1040045, Japan.
  • Carden Jennings Publ Co. Ltd., Blake Center, Ste. 200, 1224 W Main St., Charlottesville, VA 22903, USA.

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