A nationwide survey of deep fungal infections and fungal prophylaxis after hematopoietic stem cell transplantation in Japan

被引：22

作者：

Imataki, O

Kami, M

Kim, SW

Gotoh, M

Komaba, S

Kasai, M

Hashino, S

Naito, K

Masuda, M

Anan, K

Teshima, H

Togitani, K

Inoue, T

Nishimura, M

Adachi, Y

Fukuhara, T

Yamashita, T

Uike, N

Kobayashi, Y

Hamaguchi, M

Higuchi, M

Kawakami, K

Takaue, Y

机构：

[1] Natl Canc Ctr, Hematopoiet Stem Cell Transplantat Unit, Chuo Ku, Tokyo 1040045, Japan

[2] Teikyo Univ, Sch Med, Div Hematol, Tokyo 173, Japan

[3] Sapporo Hokuyu Hosp, Dept Internal Med, Sapporo, Hokkaido, Japan

[4] Hokkaido Univ, Sch Med, Dept Hematol & Gastroenterol, Sapporo, Hokkaido 060, Japan

[5] Hamamatsu Univ Sch Med, Dept Med 3, Shizuoka, Japan

[6] Tokyo Womens Med Sch, Div Hematol, Tokyo, Japan

[7] Tohoku Univ, Inst Dev Aging & Canc, Sendai, Miyagi 980, Japan

[8] Osaka City Gen Hosp, Osaka, Japan

[9] Kochi Med Sch, Dept Internal Med, Kochi, Japan

[10] Shiga Univ Med Sci, Dept Hematol, Shiga, Japan

[11] Chiba Univ, Sch Med, Dept Internal Med 2, Chiba 280, Japan

[12] Shakaihoken Kobe Cent Hosp, Kobe, Hyogo, Japan

[13] Asahikawa City Hosp, Dept Internal Med, Asahikawa, Hokkaido, Japan

[14] Natl Def Med Coll, Dept Internal Med 3, Saitama, Japan

[15] Kyushu Natl Canc Ctr, Dept Hematol, Fukuoka, Japan

[16] Kyoto Prefectural Univ Med, Dept Internal Med, Div Hematol & Oncol, Kyoto, Japan

[17] Nagoya Natl Hosp Clin & Res Ctr, Dept Hematol, Aichi, Japan

[18] Hamanomachi Gen Hosp, Dept Hematol, Fukuoka, Japan

[19] Suzuka Gen Hosp, Div Hematol, Suzuka, Mie, Japan

来源：

BONE MARROW TRANSPLANTATION | 2004年 / 33卷 / 12期

关键词：

hematopoietic stem cell transplantation; (HSCT); fungal infection; antifungal prophylaxis; reduced-intensity; stem cell transplantation (RIST);

D O I：

10.1038/sj.bmt.1704526

中图分类号：

Q6 [生物物理学];

学科分类号：

071011 ;

摘要：

We conducted a nationwide survey to de. ne incidence of deep fungal infections and fungal prophylaxis practices after HSCT. In all, 63 institutions responded. Total number of in-patient transplantations was 935: 367 autologous, 414 allogeneic myeloablative, and 154 allogeneic reduced-intensity (RIST) (n = 154). N umber of patients who were cared for in a clean room at transplant was 261 (71%) in autologous, 409 (99%) in conventional and 93 (66%) in RIST, respectively. All patients received prophylactic antifungal agents; 89%. uconazole. Number of patients who received the dosage recommended in the CDC guidelines (400 mg/day) was 135 (42%) in conventional transplant and 34 (30%) in RIST (P = 0.037). Number of patients who received. uconazole until engraftment and beyond day 75 in conventional transplant vs RIST was, respectively, 324 ( 100%) vs 109 (97%), and 39 (12%) vs 18 (16%), with no significant difference between the two groups. A total of 37 patients (4.0%) were diagnosed with deep fungal infections; autologous transplantation (0.03%), conventional transplantation (6.0%) and RIST (7.1%). Wide variations in antifungal prophylaxis practice according to the type of transplant and the institutions, and deep fungal infection remain significant problems in RIST.

引用

页码：1173 / 1179

页数：7

共 44 条

[1] Pathogenic molds (including Aspergillus species) in hospital water distribution systems:: a 3-year prospective study and clinical implications for patients with hematologic malignancies [J].

Anaissie, EJ ;

Stratton, SL ;

Dignani, MC ;

Lee, CK ;

Summerbell, RC ;

Rex, JH ;

Monson, TP ;

Walsh, TJ .

BLOOD, 2003, 101 (07) :2542-2546

[2]

[Anonymous], 1999, MMWR Recomm Rep, V48, P1

[3] Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: An international consensus [J].

Ascioglu, S ;

Rex, JH ;

de Pauw, B ;

Bennett, JE ;

Bille, J ;

Crokaert, F ;

Denning, DW ;

Donnelly, JP ;

Edwards, JE ;

Erjavec, Z ;

Fiere, D ;

Lortholary, O ;

Maertens, J ;

Meis, JF ;

Patterson, TF ;

Ritter, J ;

Selleslag, D ;

Shah, PM ;

Stevens, DA ;

Walsh, TJ .

CLINICAL INFECTIOUS DISEASES, 2002, 34 (01) :7-14

[4] Rapid and complete donor chimerism in adult recipients of unrelated donor umbilical cord blood transplantation after reduced-intensity conditioning [J].

Barker, JN ;

Weisdorf, DJ ;

DeFor, TE ;

Blazar, BR ;

Miller, JS ;

Wagner, JE .

BLOOD, 2003, 102 (05) :1915-1919

[5]

Bornhäuser M, 2001, CLIN CANCER RES, V7, P2254

[6] Regression of metastatic renal-cell carcinoma after nonmyeloablative allogeneic peripheral-blood stem-cell transplantation [J].

Childs, R ;

Chernoff, A ;

Contentin, N ;

Bahceci, E ;

Schrump, D ;

Leitman, S ;

Read, EJ ;

Tisdale, J ;

Dunbar, C ;

Linehan, WM ;

Young, NS ;

Barrett, AJ ;

Clave, E ;

Epperson, D ;

Mayo, V .

NEW ENGLAND JOURNAL OF MEDICINE, 2000, 343 (11) :750-758

[7] Evidence-based assessment of primary antifungal prophylaxis in patients with hematologic malignancies [J].

Cornely, OA ;

Ullmann, AJ ;

Karthaus, M .

BLOOD, 2003, 101 (09) :3365-3372

[8] Economic analysis of fluconazole versus amphotericin B for the treatment of candidemia in non-neutropenic patients [J].

Dranitsaris, G ;

Phillips, P ;

Rotstein, C ;

Puodziunas, A ;

Shafran, S ;

Garber, G ;

Smaill, F ;

Salit, I ;

Miller, M ;

Williams, K ;

Conly, J ;

Singer, J ;

Ioannou, S .

PHARMACOECONOMICS, 1998, 13 (05) :509-518

[9]

Dykewicz CA, 2000, BIOL BLOOD MARROW TR, V6, P659

[10]

FUKUDA T, 2003, BLOOD

← 1 2 3 4 5 →