Invasive filamentous fungal infections in allogeneic hematopoietic stem cell transplant recipients after recovery from neutropenia: Clinical, radiologic, and pathologic characteristics

Aasma Shaukat, Faris Bakri, Paul Young, Theresa Hahn, Donna Ball, Maria R. Baer, Meir Wetzler, James L Slack, Peter Loud, Myron Czuczman, Philip L. McCarthy, Thomas J. Walsh, Brahm H. Segal

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Invasive filamentous fungal infection (IFFI) is an important cause of mortality in allogeneic hematopoietic stem cell transplant (HSCT) recipients. We reviewed 22 consecutive cases of IFFI in allogeneic HSCT recipients at Roswell Park Cancer Institute. IFFI was diagnosed after neutrophil recovery in 21 patients (95%). All had received corticosteroids within 1 month prior to IFFI diagnosis. Fourteen (64%) presented with dyspnea, and only 7 (32%) were febrile. Aspergillus species were isolated in 18 (82%) cases. Thirty day mortality after IFFI diagnosis was associated with a higher mean daily dose of corticosteroids (P = 0.02) and receiving OKT3 (P = 0.01) within 1 month prior to IFFI diagnosis and serum creatinine >2 mg/dl at the time of diagnosis (P = 0.004). Histopathologic material from biopsy or autopsy was available in 15 patients (68%). In 8 (53%), the predominant lung histopathology was an acellular coagulative necrosis and hyphal angioinvasion was observed in some of these cases. These findings have generally been observed in neutropenic patients but not in non-neutropenic HSCT recipients. The predominance of coagulative necrosis in our series may reflect the high doses of corticosteroids used to treat graft-versus-host disease (GVHD), which may have disabled leukocyte trafficking and hyphal killing.

Original languageEnglish (US)
Pages (from-to)181-188
Number of pages8
JournalMycopathologia
Volume159
Issue number2
DOIs
StatePublished - Feb 2005
Externally publishedYes

Fingerprint

neutropenia
Hematopoietic Stem Cells
Neutropenia
Transplants
adrenal cortex hormones
infection
Adrenal Cortex Hormones
necrosis
Necrosis
Muromonab-CD3
Mortality
dyspnea
Graft vs Host Disease
Aspergillus
dosage
histopathology
Dyspnea
creatinine
fever
Invasive Fungal Infections

Keywords

  • Aspergillus
  • Filamentous fungal infection
  • Histology
  • Transplantation

ASJC Scopus subject areas

  • Agricultural and Biological Sciences (miscellaneous)
  • Plant Science

Cite this

Invasive filamentous fungal infections in allogeneic hematopoietic stem cell transplant recipients after recovery from neutropenia : Clinical, radiologic, and pathologic characteristics. / Shaukat, Aasma; Bakri, Faris; Young, Paul; Hahn, Theresa; Ball, Donna; Baer, Maria R.; Wetzler, Meir; Slack, James L; Loud, Peter; Czuczman, Myron; McCarthy, Philip L.; Walsh, Thomas J.; Segal, Brahm H.

In: Mycopathologia, Vol. 159, No. 2, 02.2005, p. 181-188.

Research output: Contribution to journalArticle

Shaukat, A, Bakri, F, Young, P, Hahn, T, Ball, D, Baer, MR, Wetzler, M, Slack, JL, Loud, P, Czuczman, M, McCarthy, PL, Walsh, TJ & Segal, BH 2005, 'Invasive filamentous fungal infections in allogeneic hematopoietic stem cell transplant recipients after recovery from neutropenia: Clinical, radiologic, and pathologic characteristics', Mycopathologia, vol. 159, no. 2, pp. 181-188. https://doi.org/10.1007/s11046-004-5495-0
Shaukat, Aasma ; Bakri, Faris ; Young, Paul ; Hahn, Theresa ; Ball, Donna ; Baer, Maria R. ; Wetzler, Meir ; Slack, James L ; Loud, Peter ; Czuczman, Myron ; McCarthy, Philip L. ; Walsh, Thomas J. ; Segal, Brahm H. / Invasive filamentous fungal infections in allogeneic hematopoietic stem cell transplant recipients after recovery from neutropenia : Clinical, radiologic, and pathologic characteristics. In: Mycopathologia. 2005 ; Vol. 159, No. 2. pp. 181-188.
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