Zhao C, Wang Q, Wang Y, Yan C H, Xu L P, Zhang X H, Liu K Y, Huang X J, Sun Y Q
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China.
Department of Clinical Laboratory, Peking University People's Hospital, Beijing 100044, China.
Zhonghua Xue Ye Xue Za Zhi. 2020 Aug 14;41(8):624-629. doi: 10.3760/cma.j.issn.0253-2727.2020.08.002.
To analyze the clinical characteristics and outcomes of non-aspergillus molds infection (NAMI) patients who underwent allogeneic stem cell transplantation. Total 24 patients diagnosed as proven or probable non-aspergillus molds infection after allo-HSCT at the Peking University Institute of Hematology from January 2010 to December 2016 were retrospectively reviewed. Among the 24 non-aspergillus molds infection patients, 22 (91.6%) underwent haploidentical stem cell transplantation, while 1 (4.2%) underwent matched-sibling donor transplantation, and 1 (4.2%) underwent HLA-matched unrelated donor transplantation. Ten (41.7%) patients were diagnosed as proven NAMI, and 14 (58.3%) were probable NAMI. The median time to NAMI diagnosis was 188 (2-856) d after transplantation. Five (20.8%) patients had Mucorales infection, 14 (58.3%) Rhizopus infection, 3 (12.5%) had Absidia orchidis infection, and 2 (8.3%) had Scedosporium apiospermum infection. The response rate at was 38.9% (7/18) in 18 patients who adjusted antifungal therapy based on the etiology. After a median 229 (2-2280) days follow-up after diagnosis, the 2-year overall survival was (24.0±14.5) %. The major pathogen of NAMI after allo-HSCT was Rhizopus, and the mortality of NAMI after allo-HSCT was very high due to lack of early effective therapy.
分析接受异基因干细胞移植的非曲霉属霉菌感染(NAMI)患者的临床特征及预后。回顾性分析2010年1月至2016年12月在北京大学血液病研究所接受异基因造血干细胞移植(allo-HSCT)后确诊为确诊或疑似非曲霉属霉菌感染的24例患者。在这24例非曲霉属霉菌感染患者中,22例(91.6%)接受了单倍体干细胞移植,1例(4.2%)接受了同胞全相合供者移植,1例(4.2%)接受了HLA全相合无关供者移植。10例(41.7%)患者被诊断为确诊NAMI,14例(58.3%)为疑似NAMI。确诊NAMI的中位时间为移植后188(2-856)天。5例(20.8%)患者感染毛霉目,14例(58.3%)感染根霉,3例(12.5%)感染兰氏犁头霉,2例(8.3%)感染尖端赛多孢。18例根据病因调整抗真菌治疗的患者中,有效率为38.9%(7/18)。诊断后中位随访229(2-2280)天,2年总生存率为(24.0±14.5)%。allo-HSCT后NAMI的主要病原体为根霉,由于缺乏早期有效治疗,allo-HSCT后NAMI的死亡率很高。