Genetic Risk Surveillance for Invasive Aspergillosis in Hematology Patients: A Prospective Observational Study

Abstract

Abstract Introduction The association between genetic background and the risk of invasive aspergillosis (IA) has not been addressed in Thailand. We conducted genetic risk surveillance for IA among Thai hematologic patients. Methods We conducted a prospective observational cohort study including moderate- to high-risk hematology patients at Ramathibodi Hospital. IA occurrence, relevant clinical data, and genetic analyses were assessed. Odds ratios (ORs) of IA were assessed for the presence of the selected single nucleotide polymorphism genotype using logistic regression. Results A total of 357 patients were enrolled. The most common hematologic disease was non-Hodgkin lymphoma (45.1%). IA was diagnosed in 36 patients (10.10%). The C allele of IL10 rs1800896 was associated with an increased risk of IA (adjusted OR 5.297; 95% confidence interval [CI] 2.032–13.809, p = 0.001). In multivariate Cox regression analysis, prolonged neutropenia and the C allele of IL10 rs1800896 were associated with IA (hazard ratio [HR] 12.585; 95% CI 3.866–40.967, p < 0.001 and HR 2.449; 95% CI 1.097–5.468, p = 0.042, respectively). Conclusions Carrying the C allele of IL10 rs1800896 was associated with an increased risk of IA among moderate- to high-risk Thai patients with hematologic diseases. This finding can potentially lead to a novel risk stratification scheme to further prevent IA in resource-limited settings.

Keywords

• Antifungal prophylaxis
• Genetic susceptibility
• Hematology patients
• Invasive aspergillosis