Trend Reversal in the Frequency of Mycoses in Hematological Neoplasias Autopsy Results From 1976 to 2005

Introduction: Fungal infections of internal organs are a major complication for patients with hematological neoplasias. For more than 20 years, the frequency of such mycoses has been increasing with the aggressiveness of tumor treatment. Methods: Autopsy findings over a 30-year period (1976 to 2005) from a single institution (Institute of Pathology, University of Essen) were retrospectively classified according to basic disease, frequency of mycoses, kind of mycoses, organs involved, hematopoietic transplantation, and cause of death. Results: 340 of 1591 autopsied patients with hematological neoplasias (21.4%) revealed an invasive mycosis. The proportion increased from about 10% before 1980 to some 30% in the 1990s but fell to 21% by 2005. The frequency of mycoses decreased significantly both for transplanted patients (from 47.5% to 30.3%) and for non-transplanted patients (from 29.8% to 16.4%). The rate of deaths due to mycosis also decreased. The relative frequency of candidal mycoses went down, while aspergilloses predominated. The organ most frequently involved was the lung. Discussion: The autopsy results signal a trend reversal in the leading complication of the treatment of hematological neoplasias and lend support to the assumption that antimycotic strategies are having a positive effect. Dtsch Arztebl Int 2008; 105(28-29): 501-6 DOI: 10.3238/arztebl.2008.0501