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Risk factors for invasive mold infections following allogeneic hematopoietic stem cell transplantation: A single center study of 190 recipients.
- Source :
-
Scandinavian Journal of Infectious Diseases . 2012, Vol. 44 Issue 2, p100-107. 8p. 3 Charts, 3 Graphs. - Publication Year :
- 2012
-
Abstract
- Background: Invasive mold infection (IMI) is a major cause of infection-related mortality following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: We retrospectively analyzed 190 allo-HSCT recipients at Changhai Hospital between the y 2000 and 2007. The survival rate was evaluated with Kaplan-Meier curves. Logistic and Cox regression models were used for multivariate analyses. Results: The 1st y cumulative incidence rate of IMI was 12.8%, and invasive aspergillosis was the most commonly observed IMI (85%). Multivariate logistic regression analyses showed that significant predictors of IMI were corticosteroid therapy (odds ratio (OR) 1.656, 95% confidence interval (CI) 1.047-2.621, p == 0.031), positive cytomegalovirus antigenemia (OR 5.301, 95% CI 1.902-14.772, p == 0.001), and secondary neutropenia (OR 5.250, 95% CI 1.741-15.834, p == 0.003). The mortality rate of IMI at 12 weeks after diagnosis was 60%. In Cox regression models, IMI-related mortality was related to the dose of corticosteroid (2 mg/kg/day or more) administered at the time of IMI diagnosis (hazards ratio (HR) 20.841, 95% CI 2.151-201.944, p == 0.009) and neutropenia (HR 7.043, 95% CI 1.186-41.827, p == 0.032). Conclusions: These data confirm previous findings that the incidence and mortality of IMI are mostly associated with immunodeficiency caused by immunosuppressive therapy or virus infection. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ANTIFUNGAL agents
*ADRENOCORTICAL hormones
*CHI-squared test
*CONFIDENCE intervals
*EPIDEMIOLOGY
*FISHER exact test
*HEMATOPOIETIC stem cell transplantation
*IMMUNOSUPPRESSIVE agents
*MULTIVARIATE analysis
*MYCOSES
*NEUTROPENIA
*HEALTH outcome assessment
*REGRESSION analysis
*STATISTICS
*SURVIVAL analysis (Biometry)
*T-test (Statistics)
*LOGISTIC regression analysis
*DATA analysis
*MULTIPLE regression analysis
*TREATMENT effectiveness
*DISEASE incidence
*PROPORTIONAL hazards models
*RETROSPECTIVE studies
*KAPLAN-Meier estimator
*DISEASE risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 00365548
- Volume :
- 44
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Scandinavian Journal of Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 70333208
- Full Text :
- https://doi.org/10.3109/00365548.2011.623311