Journal
BONE MARROW TRANSPLANTATION
Volume 45, Issue 12, Pages 1710-1718Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/bmt.2010.38
Keywords
hematopoietic SCT; fungal infection; invasive aspergillosis; fungal PCR; GVHD
Categories
Funding
- Swedish Orphan
Ask authors/readers for more resources
Invasive fungal infections (IFIs) are major complications after allogeneic hematopoietic SCT (HSCT). PCR-based assays able to detect fungal DNA have been reported to precede clinical diagnosis of IFI. We performed a prospective study to evaluate a PCR-based pre-emptive approach. Ninety-nine patients undergoing reduced-intensity conditioning (RIC) HSCT were followed with fungal PCR during the first 100 days post transplantation. Patients who tested positive were randomized to receive liposomal amphotericin B, or to no intervention. After day 100, PCR tests were performed only on clinical suspicion of IFI. A single positive PCR test was not associated with IFI, irrespective of treatment. After day 100, PCR tests for Aspergillus did not contribute to diagnosis of invasive aspergillosis (IA). The cumulative incidence rates of proven or probable IA during the first year after transplantation were 9%. GVHD grades II-IV (P = 0.0014), CMV-seronegative recipient with CMVseropositive donor (P <= 0.001), and conditioning with alemtuzumab (P = 0.014) were significant risk factors for developing IA in a multivariate model. In this study, PCR on peripheral blood was a poor indicator of IFI early after RIC HSCT. Aspergillus PCR tests performed on clinical suspicion after day 100 were insufficiently sensitive to be diagnostically useful. Bone Marrow Transplantation (2010) 45, 1710-1718; doi:10.1038/bmt.2010.38; published online 1 March 2010
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available