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Updated: May 24, 2026
Use of Hematopoietic Stem Cell Transplantation to Assess the Origin of Myelodysplastic Syndrome
Published on: October 3, 2018
Breakthrough mucormycosis after hematopoietic stem cell transplantation: a retrospective multiyear cohort study in
Junjie Luo1,2,3, Kaidi Song1, Baolin Tang1
1Department of Hematology, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230001, Anhui, China.
Background:
This study aimed to update the epidemiology and clinical characteristics of mucormycosis, a rare but life-threatening invasive fungal infection in hematopoietic stem cell transplantation (HSCT) recipients.
Methods:
We conducted a retrospective, single-center observational study including all consecutive HSCT recipients from November 2020 to October 2024, with follow-up through May 2025.
Results:
Among 1224 HSCT recipients receiving antifungal prophylaxis, mucormycosis was diagnosed in 49 patients (4.0%), with an incidence density of 3.4 per 100 person-years. The median time to onset was 73.0 days post-transplant (interquartile range, 30.0-223.0 days). Pulmonary involvement was present in 75.5% of cases. Rhizopus spp. accounted for the highest proportion (37.3%) among the isolated fungal genera. Multivariate analysis identified myelodysplastic syndrome (adjusted hazard ratio [aHR] = 2.65), prior fungal infection (aHR = 2.33), and severe acute graft-versus-host disease (aGvHD) (aHR = 2.96) as independent risk factors. Among 43 patients treated with antifungals, the 84-day survival rate was 46.5%. Severe aGvHD was an independent predictor of mortality. Combination therapy with amphotericin B plus posaconazole or isavuconazole was associated with a lower rate of treatment failure compared to amphotericin B alone, although this difference was not statistically significant (42.3% vs. 80.0%; P = 0.172).
Conclusions:
Mucormycosis poses a serious risk post-HSCT; early identification and optimized treatment are critical to improving outcomes.
