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.
Acknowledgements
We thank Ms Hong Meng and Mr Jinhua Cheng for their assistance in the statistical analysis.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.