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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
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Risk factors for fungal infection in patients with malignant hematologic disorders: implications for empirical

H F Guiot1, W E Fibbe, J W van 't Wout

  • 1Department of Infectious Diseases, University Hospital, Leiden, The Netherlands.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|April 1, 1994
PubMed

Insights

Patients with hematologic disorders and high-risk factors like persistent granulocytopenia or chronic graft-versus-host disease may benefit from antifungal prophylaxis to prevent invasive fungal infections.

Area of Science:

  • Infectious Diseases
  • Hematology
  • Oncology

Background:

  • Invasive fungal infections pose a significant threat to patients with malignant hematologic disorders.
  • Identifying patients at high risk is crucial for implementing effective preventive strategies.

Purpose of the Study:

  • To identify risk factors for disseminated fungal infections in patients with malignant hematologic disorders.
  • To determine eligibility for systemic antifungal prophylaxis.

Main Methods:

  • Retrospective chart review of 341 patients with malignant hematologic disorders over 10 years.
  • Analysis of 636 admissions, focusing on invasive fungal infections and outcomes.
  • Correlation of infection development with factors like granulocytopenia, graft-versus-host disease, candidal colonization, and bacteremia.

Main Results:

  • 60 invasive fungal infections occurred in 636 admissions, with 44 deaths.
  • High-risk factors included persisting granulocytopenia, poor prognosis, and chronic graft-versus-host disease.
  • High-level candidal colonization (P < .001) and preceding bacteremia were associated with candidal infections.
  • Fatal Aspergillus infections were more common in patients with chronic graft-versus-host disease post-bone marrow transplantation (P < .001).

Conclusions:

  • Patients with high-level candidal colonization and treated bacteremia are at increased risk.
  • Patients with chronic graft-versus-host disease, especially post-transplant, face a high risk of fatal fungal infections.
  • Systemic antifungal prophylaxis may benefit these identified high-risk patient groups.

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