Contributors: Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12); Hôpital Henri Mondor; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Henri Mondor Créteil; Groupe Henri Mondor-Albert Chenevier-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Henri Mondor-Albert Chenevier-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12); Centre National de Référence des Mycoses invasives et antifongiques - Mycologie moléculaire (CNRMA); Institut Pasteur Paris (IP)-Centre National de la Recherche Scientifique (CNRS); Mycologie moléculaire - Molecular Mycology; Société Française de Greffe de Moelle et de Thérapie Cellulaire, Saint-Denis, France; Centre d'infectiologie Necker-Pasteur CHU Necker; Institut Pasteur Paris (IP)-Hôpital Necker - Enfants Malades AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Paris Descartes University; Université Paris Descartes - Paris 5 (UPD5); Institut Mondor de Recherche Biomédicale (IMRB); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12); Université Paris Diderot, Sorbonne Paris Cité, Paris, France; Université Paris Diderot - Paris 7 (UPD7); Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal Paris; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" Créteil (U955 Inserm - UPEC); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12); The SAIF program was supported by acspecific grant from Institut de Veille Sanitaire, 94410, Saint-Maurice, France.; The authors are grateful to the microbiology and clinical staff from the French Mycosis Study Group who actively participated in the SAIF network. They are also grateful to the clinicians and data managers of the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC) centers who provided data for this study.
نبذة مختصرة : International audience ; Invasive aspergillosis (IA) occurs in up to 23% of allogeneic hematopoietic stem cell transplantation (HSCT) patients. Although transplant procedures have changed over time, more late cases of IA are being observed. The objective of this study was to identify the pre-and post-transplant factors of IA in a large cohort of HSCT patients mainly transplanted with reduced-intensity conditioning. This multicenter, case-control study was carried out using data collected between 2005 and 2010 by the Surveillance des Aspergilloses Invasives en France program (Institut Pasteur, Paris) and the European Society for Blood and Marrow Transplantation ProMISe registry. Four control subjects without IA were individually matched to each case based on the center, patient age, and year of the transplant. We identified 185 cases of probable and proven IA and 651 control subjects. The median date of IA after the transplant was 133 days, with 35 cases (19%) of early IA (before day 40), 33 cases (18%) of late IA (days 40 to 100), and 117 cases (63%) cases of very late IA (after day 100). In the multivariate analysis early IA was significantly associated with a lack of engraftment, whereas late and very late IA were significantly associated with more than grade II acute graft-versus-host disease (GVHD); very late IA was also significantly associated with relapse and secondary neutropenia. Two-thirds of IA cases occurred more than 100 days after HSCT with different risk factors from those occurring earlier. Prophylactic strategies should consider the specific risk factors for late and very late IA, especially GVHD, relapse after transplant, and secondary neutropenia.
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