A Single-Center Retrospective Evaluation of The Incidence and Survival of Invasive Fungal Infection in Allogeneic Stem Cell Transplant Patients

Abstract

Aim: The incidence of invasive fungal infection (IFI) is high in patients undergoing allogeneic hematopoietic stem cell transplantation. Despite new antifungal agents, IFI is still an important cause of mortality. Our study aimed to determine the risk factors of IFI and its effect on mortality. Materials and Methods: One hundred and fifty-four patients who underwent allogeneic transplantation were included in the study. Demographic characteristics, underlying disease, transplantation characteristics, and IFI status of all patients were evaluated retrospectively. The study group was divided into two: 75 patients with definite, high probability and possible IFI (group 1) and 79 patients without IFI (group 2) according to the criteria of the international committee. Results: Of 154 patients, 92 were male (59.7%) and 62 were female (40.3%) with a mean age of 41.87±14.04 years (range: 18-67 years). The most common transplant indication was acute myeloid leukemia in 58 patients (37.7%). In the analyzes performed on two groups, more IFI were observed in those who had acute graft-versus-host disease after transplantation (p= 0.035) and in those with CMV reactivation (p=0.002). The mean neutropenia duration was 30.89±20.40 in group 1 and 19.98±11.01 in group 2 (p=0.001). Underlying diseases, preparation regimen, donor compatibility, consanguineous marriage and IFI history were not found to be significant in terms of the development of IFI. The mortality rate due to IFI was found to be 24%. The mean duration of neutropenia was found to be longer in patients who died (p=0.02). Conclusion: In our study, the frequency of IFI, risk factors and mortality rates were found to be similar to the literature. It would be appropriate for each center to evaluate the frequency of IFI and the risk factors that increase it and decide which treatment strategy is more beneficial for their patients.

Keywords

• allogeneic transplantation
• invasive fungal infections
• risk factors
• mortality markers