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
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
收藏
页码:1173 / 1179
页数:7
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