RT Journal Article
T1 Influence of invasive aspergillosis during acute leukaemia treatment on survival after allogeneic stem cell transplantation: a prospective study of the EBMT Infectious Diseases Working Party
A1 Penack, Olaf
A1 Tridello, Gloria
A1 Salmenniemi, Urpu
A1 Martino, Rodrigo
A1 Khanna, Nina
A1 Perruccio, Katia
A1 Fagioli, Franca
A1 Richert-Przygonska, Monika
A1 Labussière-Wallet, Hélène
A1 Maertens, Johan
A1 Jubert, Charlotte
A1 Aljurf, Mahmoud
A1 Pichler, Herbert
A1 Kriván, Gergely
A1 Kunadt, Desiree
A1 Popova, Marina
A1 Gabriel, Melissa
A1 Calore, Elisabetta
A1 Blau, Igor Wolfgang
A1 Benedetti, Fabio
A1 Itäla-Remes, Maija
A1 de Kort, Elizabeth
A1 Russo, Domenico
A1 Faraci, Maura
A1 Ménard, Anne-Lise
A1 Borne, Peter von dem
A1 Poiré, Xavier
A1 Yesilipek, Akif
A1 Gozdzik, Jolanta
A1 Yeğin, Zeynep Arzu
A1 Yanez, Lucrecia
A1 Facchini, Luca
A1 Van Gorkom, Gwendolyn
A1 Thurner, Lorenz
A1 Kocak, Ulker
A1 Sampol Mayol, Antonia
A1 Zuckerman, Tsila
A1 Bierings, Marc
A1 Mielke, Stephan
A1 Ciceri, Fabio
A1 Wendel, Lotus
A1 Knelange, Nina
A1 Mikulska, Malgorzata
A1 Averbuch, Dina
A1 Styczynski, Jan
A1 Camara, Rafael de la
A1 Cesaro, Simone
AB Infections are the main reason for mortality during acute leukaemia treatment and invasive aspergillosis (IA) is a major concern. Allogeneic stem cell transplantation (alloSCT) is a standard therapy and often is the only live-saving procedure in leukaemia patients. The profound immunodeficiency occurring after alloSCT led to high IA-associated mortality in the past. Therefore, patients with IA were historically considered transplant-ineligible. Recently, there has been improvement of anti-fungal management including novel anti-fungal agents. As a result, more leukaemia patients with IA are undergoing alloSCT. Outcome has not been prospectively assessed.We performed a prospective study in acute leukaemia patients undergoing alloSCT to analyse the impact of a prior history of probable or proven IA (pre-SCT IA). The primary endpoint was 1-year non-relapse mortality (NRM). Relapse free survival and overall survival were analysed as secondary endpoints.1439 patients were included between 2016 and 2021. The incidence of probable or proven pre-SCT IA was 6.0% (n = 87). The cumulative incidence of 1-year NRM was 17.3% (95% CI 10.2-26.0) and 11.2% (9.6-13.0) for patients with and without pre-SCT IA. In multivariate analyses the hazard ratio (HR) for 1-year NRM was 2.1 (1.2-3.6; p = 0.009) for patients with pre-SCT IA. One-year relapse-free survival was inferior in patients with pre-SCT IA (59.4% [48.3-68.9] vs. 70.4 [67.9-72.8]; multivariate HR 1.5 [1.1-2.1]; p = 0.02). Consequently, 1-year overall survival was lower in patients with pre-SCT IA: (68.8% [57.8-77.4] vs. 79.0% [76.7-81.1]; multivariate HR 1.7 [1.1-2.5]; p = 0.01).Pre-SCT IA remains to be significantly associated with impaired alloSCT outcome. On the other hand, more than two thirds of patients with pre-SCT IA were alive at one year after alloSCT. IA is not anymore an absolute contraindication for alloSCT because the majority of patients with IA who undergo alloSCT benefit from this procedure.There was no external funding source for this study.
PB Elsevier
YR 2024
FD 2024-01
LK https://hdl.handle.net/20.500.13003/20132
UL https://hdl.handle.net/20.500.13003/20132
LA eng
NO Penack O, Tridello G, Salmenniemi U, Martino R, Khanna N, Perruccio K, et al. Influence of invasive aspergillosis during acute leukaemia treatment on survival after allogeneic stem cell transplantation: a prospective study of the EBMT Infectious Diseases Working Party. EClinicalMedicine. 2024 Jan;67:102393.
DS Docusalut
RD 30 jun. 2026