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Title: Invasive fungal diseases in haematopoietic cell transplant recipients and in patients with acute myeloid leukaemia or myelodysplasia in Brazil
Authors: Nucci, Marcio
Garnica, M.
Gloria, A. B.
Lehugeur, D. S.
Dias, V. C. H.
Palma, L. C.
Cappellano, P. [UNIFESP]
Fertrin, K. Y.
Carlesse, F. [UNIFESP]
Simoes, B.
Bergamasco, M. D. [UNIFESP]
Cunha, C. A.
Seber, Adriana [UNIFESP]
Ribeiro, M. P. D.
Queiroz-Telles, F.
Lee, Maria Lúcia de Martino [UNIFESP]
Chauffaille, M. L. [UNIFESP]
Silla, L.
Souza, C. A. de
Colombo, Arnaldo Lopes [UNIFESP]
Universidade Federal do Rio de Janeiro (UFRJ)
Universidade Federal de Minas Gerais (UFMG)
Univ Fed Rio Grande do Sul
Universidade Federal do Paraná (UFPR)
Universidade de São Paulo (USP)
Universidade Federal de São Paulo (UNIFESP)
Universidade Estadual de Campinas (UNICAMP)
Keywords: Aspergillosis
haematological malignancy
invasive fungal disease
Issue Date: 1-Aug-2013
Publisher: Wiley-Blackwell
Citation: Clinical Microbiology and Infection. Hoboken: Wiley-Blackwell, v. 19, n. 8, p. 745-751, 2013.
Abstract: Invasive fungal disease (IFD) shows distinct regional incidence patterns and epidemiological features depending on the geographic region. We conducted a prospective survey in eight centres in Brazil from May 2007 to July 2009. All haematopoietic cell transplant (HCT) recipients and patients with acute myeloid leukaemia (AML) or myelodysplasia (MDS) were followed from admission until 1year (HCT) or end of consolidation therapy (AML/MDS). the 12-month cumulative incidence (CI) of proven or probable IFD was calculated, and curves were compared using the Grey test. Among 237 AML/MDS patients and 700 HCT recipients (378 allogeneic, 322 autologous), the 1-year CI of IFD in AML/MDS, allogeneic HCT and autologous HCT was 18.7%, 11.3% and 1.9% (p<0.001), respectively. Fusariosis (23 episodes), aspergillosis (20 episodes) and candidiasis (11 episodes) were the most frequent IFD. the 1-year CI of aspergillosis and fusariosis in AML/MDS, allogeneic HCT and autologous HCT were 13.4%, 2.3% and 0% (p<0.001), and 5.2%, 3.8% and 0.6% (p0.01), respectively. the 6-week probability of survival was 53%, and was lower in cases of fusariosis (41%). We observed a high burden of IFD and a high incidence and mortality for fusariosis in this first multicentre epidemiological study of IFD in haematological patients in Brazil.
ISSN: 1198-743X
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