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Invasive aspergillosis in patients with solid tumors
Norio Ohmagari1, Isaam I Raad, Ray Hachem
1Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer
|September 29, 2004
Summary
Invasive aspergillosis (IA) is rare in solid tumor patients, often affecting the lungs or brain. Steroid use and low lymphocyte counts were common, with over half responding to antifungal therapy.
Area of Science:
- Mycology
- Oncology
- Infectious Diseases
Background:
- Invasive aspergillosis (IA) is infrequently documented in patients diagnosed with solid tumors.
- This study investigates the characteristics and outcomes of IA in this specific patient population.
Purpose of the Study:
- To retrospectively analyze episodes of invasive aspergillosis in patients with solid tumors.
- To identify risk factors, clinical presentations, and treatment responses in this cohort.
Main Methods:
- Retrospective review of 13 definite or probable IA episodes (European Organization for Research and Treatment of Cancer criteria) between 1994-2003.
- Analysis of patient demographics, tumor types, prior treatments (systemic steroids), lymphocyte counts, and radiological findings.
Main Results:
- Nine cases involved pulmonary IA, and three involved brain IA.
- Risk factors included primary/metastatic brain tumors (54%) and recent systemic steroid use (46%).
- Lymphopenia (<500/microL) was prevalent (69%), while neutropenia was rare (1 patient). Nodular infiltrates and cavities were common radiologic findings.
Conclusions:
- Invasive aspergillosis in solid tumor patients presents unique risk factors, including brain tumors and steroid immunosuppression.
- Antifungal treatment showed a 54% response rate, suggesting potential therapeutic benefit despite underlying malignancy.