1.Study On Early Diagnosis Of Invasive Aspergilosis With Serum Galactomannan Detection In Patients With Hematological Disease 2.Invasive Fungal Infections After Allogeneic Hematopoietic Stem Cell Transplantation (Allo-HSCT) And Related Risk Factors

Objective To evaluate the value of serum galactomannan(GM) detection for early diagnosis of invasive aspergillosis(IA) in patients with hematological disease.Methods The serum GM concentration in 96 sera from 72 patients was detected by Platelia Aspergillus double-sandwich enzyme linked immunosorbent assay(PADSELISA).According to the diagnostic criteria of invasive fungal infections in China,the diagnostic changes were evaluated,the sensitivity, specificity and predictive values were calculated.Results The sensitivity and specificity of the PADSELISA were 82.3%and 88.7%and the positive and negative predictive values were 86.8%and 87.2%respectively.There were 22 positive cases,and 50 negative cases,and the probable IA cases were increased from 19 to 28 after the GM detection.Moreover,the serous level of galactomannan was correlated with the prognosis of the IA.Conclusions The PADSELISA for GM detection is a reliable method for early diagnosis and treatment of IA in patients with hematological disease. Objective In order to analyze the incidence and high-risk factors of invasive fungal infections among recipients of allogeneic hematopoietic stem cell transplantation (alIo-HSCT).Methods 180 cases of allo-HSCr were enrolled in this study. The incidence and risk factors of IFI were analyzed by method of Kaplan-meier and Cox regression model.Results An incidence of 19.5%of IFI in 35 cases were detected, with 1 case proven and 34 cases probably diagnosed,which was composed of 18 cases(51.4%) of aspergillosis and 17 cases(48.6%) of candidosis.There was significant difference in one-year overall survival rate between patients with(34.3%) or without(53.8%) IFI.In univariate analysis,risk factors of IFI included:pretransplant fungal infection or colonization, unrelated donor(peripheral blood or bone marrow stem cell) transplantation,acute GVHD,extensive chronic GVHD and the use of methylprednisolone.In multi-variate analysis,the following risk factors of IFI were found:unrelated donor for allogeneic peripheral blood or bone marrow stem cell transplantation,acute GVHD and pretransplant fungal infection or colonization acute GVHD(RR:2.399,1.589,and 0.836).Conclusions It is concluded that IFI is a frequent complication and one of the leading causes of mortality among recipients of allo-HSCT.As for patients with higher risk of IFI,early interventions should be taken.