Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangdong, China.
Infection. 2019 Apr;47(2):275-284. doi: 10.1007/s15010-018-01265-3. Epub 2019 Feb 7.
Invasive fungal disease (IFD) and graft-versus-host disease (GVHD) are major causes of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the impacts of IFD on chronic GVHD remain unknown.
We conducted a retrospective study of 510 patients with hematologic malignancy undergoing allo-HSCT to explore the effects of IFD on chronic GVHD.
The 2-year cumulative incidences of overall (limited and extensive) and extensive chronic GVHD post-transplantation were higher in patients with IFD compared with those without IFD (69.5% ± 4.2% versus 32.9% ± 2.4%, P < .001; 43.0% ± 5.2% versus 6.6% ± 1.4%, P < .001, respectively). Moreover, the patients with IFD had higher 5-year transplant-related mortality, lower 5-year overall survival and lower 5-year disease-free survival (29.8% ± 4.3% versus 9.8% ± 1.6%, P < .001; 50.5% ± 4.9% versus 71.3% ± 2.4%, P < .001 and 48.8% ± 4.7% versus 71.8% ± 2.3%, P < .001, respectively). Multivariable analyses demonstrated that IFD increased the risk of chronic GVHD.
Our results suggest that IFD significantly contributes to the development of chronic GVHD after allo-HSCT.
侵袭性真菌病（IFD）和移植物抗宿主病（GVHD）是异基因造血干细胞移植（allo-HSCT）后发病率和死亡率的主要原因。然而，IFD 对慢性 GVHD 的影响尚不清楚。
我们对 510 例接受 allo-HSCT 的血液系统恶性肿瘤患者进行了回顾性研究，以探讨 IFD 对慢性 GVHD 的影响。
IFD 组患者移植后 2 年总体（局限性和广泛性）和广泛性慢性 GVHD 的累积发生率高于无 IFD 组（69.5%±4.2%比 32.9%±2.4%，P<0.001；43.0%±5.2%比 6.6%±1.4%，P<0.001）。此外，IFD 组患者 5 年移植相关死亡率较高，总生存率和无病生存率较低（29.8%±4.3%比 9.8%±1.6%，P<0.001；50.5%±4.9%比 71.3%±2.4%，P<0.001 和 48.8%±4.7%比 71.8%±2.3%，P<0.001）。多变量分析表明，IFD 增加了慢性 GVHD 的风险。
我们的研究结果表明，IFD 显著增加 allo-HSCT 后慢性 GVHD 的发生风险。
