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Blood, 1 November 2006, Vol. 108, No. 9, pp. 2928-2936. Prepublished online as a Blood First Edition Paper on May 23, 2006; DOI 10.1182/blood-2006-03-008706. This Article Full Text (PDF) All Versions of this Article: blood-2006-03-008706v1 108/9/2928    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Martino, R. Articles by Einsele, H. Search for Related Content PubMed PubMed Citation Articles by Martino, R. Articles by Einsele, H. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted March 13, 2006 Accepted May 10, 2006 Impact of the intensity of the pre-transplant conditioning regimen in patients with prior invasive aspergillosis undergoing allogeneic hematopoietic stem cell transplantation: a retrospective survey of the infectious diseases working party of the european group for blood and marrow transplantation Rodrigo Martino*, Rocio Parody, T Fukuda, Johan Maertens, Koen Theunissen, Aloysius Ho, Ghulam J Mufti, N Kroger, Arnold R Zander, Dominik Heim, Monika Paluszewska, Dominik Selleslag, K Steinerova, Per Ljungman, Simone Cesaro, A Nihtinen, Catherine Cordonnier, Lourdes Vazquez, M Lopez-Duarte, J Lopez, Rafael Cabrera, Montserrat Rovira, S Neuburger, Oliver Cornely, A E Hunter, Kieren A Marr, H J Dornbusch, and Hermann Einsele Hospital de la Santa Creu i Sant Pau Hematopoietic Stem Cell Transplantation Unit, National Cancer Center Hospital, Japan University Hospital Gasthuisberg, Leuven, Belgium King's College London School of Medicine, London, United Kingdom UKE Hamburg, Germany University Hospital of Basel, C.H. Medical University of Warsaw, Poland AZ Sint Jan, Brugge, Belgium Charles University Hospital, Pilsen, Czec Republic Karolinska University Hospital, Stockholm, Sweden Pediatric Hematology/Oncology, Department of Pediatrics, University of Padua, Italy University Central Hospital of Helsinki, Finland Hopital Henri Mondor, Creteil, France Hospital Clinico de Salamanca Marques de Valdecilla Hospital, Santander, Spain Hospital Ramon y Cajal, Madrid Hospital Puerta de Hierro, Madrid Hospital Clinico de Barcelona Charite Campus Virchow Klinikum, Berlin, Germany University Hospital Cologne, Germany University Hospital of Leicester Fred Hutchinson Cancer Research Center, Seattle, WA, USA Division of Pediatric Hematology and Oncology, Medical University of Graz, Austria Wuerzburg University Medical Center, Wuerzburg, Germany * Corresponding author; email: rmartino{at}santpau.es. In this retrospective study we analyzed the outcomes of 129 patients who underwent an allogeneic hematopoietic stem cell transplantation (alloHSCT) and had a history of probable or proven invasive aspergillosis (IA), of whom 57 (44%) received a reduced-intensity conditioning (RIC). Overall, 27 cases of IA progressed after the alloHSCT (cumulative incidence (CumInc) at 2 years, 22%). The variables that increased the 2 yr. CumInc of IA progression were: (i) longer duration of neutropenia after transplant, (ii) advanced status of the underlying disease, and (iii) less than 6 weeks from start of systemic anti-Aspergillus therapy and the alloHSCT. In addition, (iv) Conventional myeloablative conditioning increased the risk of progression early post-transplant (< day +30) only, while three variables increased the risk beyond day +30 were: (v) cytomegalovirus disease, (vi) bone marrow or cord blood as source of stem cells, and (vii) grade II-IV acute GVHD. A risk model for progression was generated, defined as low (0-1 risk factors, 6% incidence), intermediate (2-3 risk factors, 27% incidence) or high risk (> 3 risk factors, 72% incidence)[P<0.001]. These findings may help in the interpretation and design of future studies on secondary prophylaxis of IA after an alloHSCT. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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