Zhang P, Jiang E-L, Yang D-L, Yan Z-S, Huang Y, Wei J-L, Wang M, Ma Q-L, Liu Q-G, Zou D-H, He Y, Qiu L-G, Feng S-Z, Han M-Z
Hematopoietic Stem Cell Transplantation Center, Institute of Hematology & Blood Disease Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Tianjin, China.
Transpl Infect Dis. 2010 Aug 1;12(4):316-21. doi: 10.1111/j.1399-3062.2010.00497.x. Epub 2010 Feb 17.
Invasive fungal infections (IFI) are frequent complications of allogeneic hematopoietic stem cell transplantation (SCT) and major causes of a poor prognosis. Analysis of risk factors and prognosis of IFI are important for the control of IFI.
We retrospectively reviewed the medical records of all allogeneic SCT recipients from January 2000 to December 2007. For the homogeneity of analysis, only 286 patients with no history of IFI were included.
Fifty-five cases of IFI were identified, corresponding to cumulative incidence of 19.8%. Different overall survival rates were recorded in patients with or without IFI (20.3% vs. 55.3%, P=0.004). Multivariate analysis identified 2 risk factors of IFI: use of high-dose steroid and cytomegalovirus infections, and risk stratification can classify the patients into 3 subgroups with different incidences of IFI (9.2%, 25.4%, and 34.1%, P=0.0007). Further analysis confirmed use of steroid as a risk factor of inferior prognosis in IFI cases (0 vs. 57.1%, P<0.0001), which was due to higher rates of IFI-related mortality (64.7% vs. 23.9%, P=0.018).
Post-transplant IFI was an unfavorable prognostic factor of the SCT recipients, and risk stratification can identify patients with high risk of IFI. Use of steroid played an important role in the pathogenesis as well as prognosis of IFI.
侵袭性真菌感染（IFI）是异基因造血干细胞移植（SCT）常见的并发症，也是预后不良的主要原因。分析IFI的危险因素和预后对控制IFI具有重要意义。
我们回顾性分析了2000年1月至2007年12月期间所有异基因SCT受者的病历。为保证分析的同质性，仅纳入286例无IFI病史的患者。
共确诊55例IFI，累积发病率为19.8%。有或无IFI的患者总生存率不同（20.3%对55.3%，P = 0.004）。多因素分析确定了IFI的2个危险因素：使用大剂量类固醇和巨细胞病毒感染，风险分层可将患者分为3个IFI发病率不同的亚组（9.2%、25.4%和
