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

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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