Influence of pre-existing invasive aspergillosis on allo-HSCT outcome: A retrospective EBMT analysis by the Infectious Diseases and Acute Leukemia Working Parties

O. Penack*, G. Tridello, J. Hoek, G. Socié, D. Blaise, J. Passweg, P. Chevallier, C. Craddock, N. Milpied, H. Veelken, J. Maertens, P. Ljungman, J. Cornelissen, A. Thiebaut-Bertrand, B. Lioure, M. Michallet, S. Iacobelli, A. Nagler, M. Mohty, S. Cesaro

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)418-423
Number of pages6
JournalBone Marrow Transplantation
Volume51
Issue number3
DOIs
StatePublished - 1 Mar 2016

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