European Organization for the Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) host factors and invasive fungal infections in patients with haematological malignancies

Fulfilment of host factors defined by the revised European Organization for the Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria is required for establishing the diagnosis of possible or probable invasive fungal infection (IFI). This casecontrol study evaluates EORTC/MSG host factors among patients with haematological malignancies. Fifty-eight patients with haematological malignancies who developed probable (n38) or proven (n20) IFI over a 5 year period were retrospectively evaluated regarding EORTC/MSG host factors. Results were compared with those obtained from patients with haematological malignancies who did not develop IFI (116 patients who received systemic antifungal prophylaxis or empirical therapy and 116 patients who did not; all data collected in 2010). Fourteen patients had invasive yeast infection and 44 patients had invasive mould infection (IMI). Prolonged neutropenia (35/58, 60 versus 29/116, 25), prolonged systemic corticosteroid (cut-off 21 days: 13/58, 22 versus 6/116, 5; cut-off 14 days: 18/58, 31 versus 9/116, 8) and T cell suppressive therapy (35/44, 80 versus 69/116, 59) were significantly associated with development of IFI/IMI in our cohort. Previous allogeneic stem cell transplantation (SCT; 6 months prior to episode) was not significantly associated with development of IMI (8/44, 18 versus 22/116, 19), while recent SCT (6 months prior to episode) was (11/44, 25 versus 12/116, 10). We conclude that host factors according to revised EORTC/MSG criteria were significantly associated with the development of IFI/IMI in our patients. Previous allogeneic SCT was not a predisposing host factor for the development of IMI. Concerning prolonged corticosteroid treatment, a cut-off of 14 days seems preferable to the proposed cut-off.