Antifungal prophylaxis of patients undergoing allogenetic hematopoietic stem cell transplantation in China: a multicenter prospective observational study.
Antifungal prophylaxis of patients undergoing allogenetic hematopoietic stem cell transplantation in China: a multicenter prospective observational study.
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DOI：
10.1186/s13045-016-0305-y
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发表时间：
2016-09-23
影响因子：
28.5
通讯作者：
Zhang X
中科院分区：
文献类型：
--
作者：
Gao L;Sun Y;Meng F;Han M;Huang H;Wu D;Yu L;Ren H;Huang X;Zhang X
抗真菌预防目前被认为是同种异体造血干细胞移植（allo-HSCT）情况下的金标准。然而，中国有关预防侵袭性真菌病（IFD）的流行病学信息尚不清楚。我们报告了中国第一个针对异基因造血干细胞移植患者 IFD 预防和管理的大规模（1053 名患者）观察性研究。一级抗真菌预防（PAP）、二级抗真菌预防（SAP）和非预防后IFD的发生率分别为22.7%、38.6%和68.6%（P = 0.0000）。 PAP 患者从移植到 IFD 的中位时间为 45 天，SAP 患者为 18 天，非预防患者为 12 天。曲霉属代表最常见的真菌感染类型。患有 PAP 的异基因 HSCT 患者发生 IFD 的独立危险因素包括年龄、人类白细胞抗原 (HLA) 单倍体相合或匹配的无关供者、白蛋白水平降低以及使用伊曲康唑作为预防性抗真菌药物。在 SAP 移植受者中，IFD 没有显着的危险因素。 PAP组、SAP组和无预防组的总生存率（OS）分别为85.07、78.80和74.82（P = 0.01）。本观察性研究表明，预防IFD有助于降低allo-HSCT后IFD的发生率并提高患者的OS。
Antifungal prophylaxis is currently regarded as the gold standard in situations with allo-genetic hematopoietic stem cell transplantation (allo-HSCT). However, the epidemiological information regarding prophylaxis of invasive fungal diseases (IFDs) is not clear in China. We report the first large-scale (1053 patients) observational study of the prophylaxis and management of IFDs among patients with allo-HSCT in China. The incidence rates of IFD after primary antifungal prophylaxis (PAP), secondary antifungal prophylaxis (SAP), and non-prophylaxis were 22.7 vs. 38.6 vs. 68.6 %, respectively (P = 0.0000). The median time from transplantation to IFD was 45 days in PAP patients, 18 days in SAP patients, and 12 days in non-prophylaxis patients. Aspergillus spp. represents the most common type of fungal infection. Independent risk factors for IFD in allo-HSCT patients with PAP were age, having human leukocyte antigen (HLA)-haploidentical or matched unrelated donor, decreased albumin levels, and the use of itraconazole as the prophylactic antifungal agent. Among SAP transplant recipients, there was no significant risk factor for IFDs. The incidence rates of overall survival (OS) in the PAP, SAP, and no prophylaxis groups were 85.07, 78.80, and 74.82, respectively (P = 0.01). This observational study indicates that prophylaxis of IFD is helpful to reduce the incidence of IFDs and improve the OS of patients after allo-HSCT.
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影响因子：
28.5
作者：
Lv M;Huang XJ
通讯作者：
Huang XJ
影响因子：
4.3
作者：
Girmenia, Corrado;Raiola, Anna Maria;Locasciulli, Anna
通讯作者：
Locasciulli, Anna
影响因子：
11.8
作者：
Maria Aguado, Jose;Vazquez, Lourdes;Cuenca-Estrella, Manuel
通讯作者：
Cuenca-Estrella, Manuel
影响因子：
5.2
作者：
Allinson, Katherine;Kolve, Hedwig;Groll, Andreas H.
通讯作者：
Groll, Andreas H.
DOI：
10.1007/978-1-60327-353-4_1
发表时间：
2013-01-01
期刊：
Methods in molecular biology (Clifton, N.J.)
影响因子：
--
作者：
Johnson, Gemma;Nolan, Tania;Bustin, Stephen A
通讯作者：
Bustin, Stephen A