Risk Factors Of Invasive Fungal Disease After Allogeneic Hematopoietic Stem Cell Transplantation

Objective To examine the risk factors and incidence of invasive fungal disease(IFD)in recipients undergoing allogeneic hematopeietic stem cell transplantation(allo-HSCT).Methods We performed a study of eighty-two patients undergoing allo-HSCT from January 2007 to November 2013.We defined IFD using standard criteria, selected proven,probable and possible cases for retrospective review.Results For total 82 cases,22 cases of IFD(26.82%)were identified,including 5 proven IFD (22.72%),7 Probable IFD (31.81%) and 10 possible IFD (45.45%) cases respectively.The infection occurred a median of+162 days after allo-HSCT. The cumulative incidence rate of IFD was 11.1% at 3months,15.3% at 6months and 22.6% at 12months post-transplantation. Univariate analysis showed that neutrophil<0.5×109/ L more than 14 days,previous history of IFD as risk factors of early IFD after allo-HSCT, and previous history of IFD,glucocorticosteroid use, antibiotics use,chronic GVHD as risk factors of late IFD.In multivariate analysis,the early risk factors were HLA unmatched, previous history of IFD,while glucocorticosteroid use, antibiotics use were risk factors of late IFD.Conclusion:IFD was one of the severe complications after allo-HSCT with high incidence and mortality. Its risk factors were HLA unmatched,previous history of IFD,neutrophil<0.5×109/L more than 14 days, glucocorticosteroid use,antibiotics use,chronic GVHD.