Impact of Antifungal Prophylaxis Continuation or Discontinuation After Allogeneic Hematopoietic Cell Transplant on the Incidence of Invasive Mold Infection.
| Title: | Impact of Antifungal Prophylaxis Continuation or Discontinuation After Allogeneic Hematopoietic Cell Transplant on the Incidence of Invasive Mold Infection. |
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| Authors: | Ross, Justine Abella, Lee, Brian, Ma, Huiyan, Tegtmeier, Bernard, Nanayakkara, Deepa, Dickter, Jana, Spielberger, Ricardo, Smith, Eileen, Pullarkat, Vinod, Forman, Stephen J, Taplitz, Randy, Nakamura, Ryotaro, Malki, Monzr Al, Dadwal, Sanjeet Singh |
| Source: | Open Forum Infectious Diseases; Aug2024, Vol. 11 Issue 8, p1-8, 8p |
| Subject Terms: | HEMATOPOIETIC stem cell transplantation, ACUTE myeloid leukemia, HOSPITAL admission & discharge, OVERALL survival, UNIVARIATE analysis |
| Abstract: | Background Continuing antifungal prophylaxis (AFPx) to prevent invasive mold infections (IMIs) in recipients of allogeneic hematopoietic cell transplantation (alloHCT) after primary hospital discharge from alloHCT admission varies among transplant centers despite recommendations to continue prophylaxis through day +75. Characteristics driving AFPx prescribing at hospital discharge and outcomes are unknown. Methods In this retrospective analysis, we reviewed patients continuing AFPx vs no AFPx at hospital discharge. We included patients with a hospital stay ≥7 days and ≤40 days. We excluded patients with a history of IMI prior to alloHCT, new IMI during admission, or death prior to discharge. Our primary objective was incidence of probable or proven IMI per the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Our secondary objectives were nonrelapse mortality at day +100, overall survival at day +100, and characteristics driving AFPx discontinuation at hospital discharge. Results Of the 430 patients identified, 387 met inclusion criteria. At discharge, 56% (217/387) continued AFPx, and 44% (170/387) had no AFPx. At day +100, 3 probable IMI cases occurred in the group with continued AFPx vs 1 probable IMI case in the no-AFPx group (no proven IMI). Univariate analysis showed no difference in cumulative incidence of probable IMI (P =.440), nonrelapse mortality (P =.072), and overall survival (P =.855) between groups. Multivariable logistic regression demonstrated that patients were less likely to continue AFPx if they had a diagnosis other than acute myeloid leukemia, a length of stay ≤30 days, acute graft-vs-host disease grade 0 or 1, and corticosteroid use ≤5 days. Conclusions There was no difference in probable IMI at day +100 after alloHCT based on continuing vs discontinuing AFPx at hospital discharge after alloHCT admission supporting a risk-adapted prophylaxis approach. [ABSTRACT FROM AUTHOR] |
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| Database: | Complementary Index |
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| Items | – Name: Title Label: Title Group: Ti Data: Impact of Antifungal Prophylaxis Continuation or Discontinuation After Allogeneic Hematopoietic Cell Transplant on the Incidence of Invasive Mold Infection. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Ross%2C+Justine+Abella%22">Ross, Justine Abella</searchLink><br /><searchLink fieldCode="AR" term="%22Lee%2C+Brian%22">Lee, Brian</searchLink><br /><searchLink fieldCode="AR" term="%22Ma%2C+Huiyan%22">Ma, Huiyan</searchLink><br /><searchLink fieldCode="AR" term="%22Tegtmeier%2C+Bernard%22">Tegtmeier, Bernard</searchLink><br /><searchLink fieldCode="AR" term="%22Nanayakkara%2C+Deepa%22">Nanayakkara, Deepa</searchLink><br /><searchLink fieldCode="AR" term="%22Dickter%2C+Jana%22">Dickter, Jana</searchLink><br /><searchLink fieldCode="AR" term="%22Spielberger%2C+Ricardo%22">Spielberger, Ricardo</searchLink><br /><searchLink fieldCode="AR" term="%22Smith%2C+Eileen%22">Smith, Eileen</searchLink><br /><searchLink fieldCode="AR" term="%22Pullarkat%2C+Vinod%22">Pullarkat, Vinod</searchLink><br /><searchLink fieldCode="AR" term="%22Forman%2C+Stephen+J%22">Forman, Stephen J</searchLink><br /><searchLink fieldCode="AR" term="%22Taplitz%2C+Randy%22">Taplitz, Randy</searchLink><br /><searchLink fieldCode="AR" term="%22Nakamura%2C+Ryotaro%22">Nakamura, Ryotaro</searchLink><br /><searchLink fieldCode="AR" term="%22Malki%2C+Monzr+Al%22">Malki, Monzr Al</searchLink><br /><searchLink fieldCode="AR" term="%22Dadwal%2C+Sanjeet+Singh%22">Dadwal, Sanjeet Singh</searchLink> – Name: TitleSource Label: Source Group: Src Data: Open Forum Infectious Diseases; Aug2024, Vol. 11 Issue 8, p1-8, 8p – Name: Subject Label: Subject Terms Group: Su Data: <searchLink fieldCode="DE" term="%22HEMATOPOIETIC+stem+cell+transplantation%22">HEMATOPOIETIC stem cell transplantation</searchLink><br /><searchLink fieldCode="DE" term="%22ACUTE+myeloid+leukemia%22">ACUTE myeloid leukemia</searchLink><br /><searchLink fieldCode="DE" term="%22HOSPITAL+admission+%26+discharge%22">HOSPITAL admission & discharge</searchLink><br /><searchLink fieldCode="DE" term="%22OVERALL+survival%22">OVERALL survival</searchLink><br /><searchLink fieldCode="DE" term="%22UNIVARIATE+analysis%22">UNIVARIATE analysis</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background Continuing antifungal prophylaxis (AFPx) to prevent invasive mold infections (IMIs) in recipients of allogeneic hematopoietic cell transplantation (alloHCT) after primary hospital discharge from alloHCT admission varies among transplant centers despite recommendations to continue prophylaxis through day +75. Characteristics driving AFPx prescribing at hospital discharge and outcomes are unknown. Methods In this retrospective analysis, we reviewed patients continuing AFPx vs no AFPx at hospital discharge. We included patients with a hospital stay ≥7 days and ≤40 days. We excluded patients with a history of IMI prior to alloHCT, new IMI during admission, or death prior to discharge. Our primary objective was incidence of probable or proven IMI per the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Our secondary objectives were nonrelapse mortality at day +100, overall survival at day +100, and characteristics driving AFPx discontinuation at hospital discharge. Results Of the 430 patients identified, 387 met inclusion criteria. At discharge, 56% (217/387) continued AFPx, and 44% (170/387) had no AFPx. At day +100, 3 probable IMI cases occurred in the group with continued AFPx vs 1 probable IMI case in the no-AFPx group (no proven IMI). Univariate analysis showed no difference in cumulative incidence of probable IMI (P =.440), nonrelapse mortality (P =.072), and overall survival (P =.855) between groups. Multivariable logistic regression demonstrated that patients were less likely to continue AFPx if they had a diagnosis other than acute myeloid leukemia, a length of stay ≤30 days, acute graft-vs-host disease grade 0 or 1, and corticosteroid use ≤5 days. Conclusions There was no difference in probable IMI at day +100 after alloHCT based on continuing vs discontinuing AFPx at hospital discharge after alloHCT admission supporting a risk-adapted prophylaxis approach. [ABSTRACT FROM AUTHOR] – Name: Abstract Label: Group: Ab Data: <i>Copyright of Open Forum Infectious Diseases is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1093/ofid/ofae409 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 8 StartPage: 1 Subjects: – SubjectFull: HEMATOPOIETIC stem cell transplantation Type: general – SubjectFull: ACUTE myeloid leukemia Type: general – SubjectFull: HOSPITAL admission & discharge Type: general – SubjectFull: OVERALL survival Type: general – SubjectFull: UNIVARIATE analysis Type: general Titles: – TitleFull: Impact of Antifungal Prophylaxis Continuation or Discontinuation After Allogeneic Hematopoietic Cell Transplant on the Incidence of Invasive Mold Infection. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Ross, Justine Abella – PersonEntity: Name: NameFull: Lee, Brian – PersonEntity: Name: NameFull: Ma, Huiyan – PersonEntity: Name: NameFull: Tegtmeier, Bernard – PersonEntity: Name: NameFull: Nanayakkara, Deepa – PersonEntity: Name: NameFull: Dickter, Jana – PersonEntity: Name: NameFull: Spielberger, Ricardo – PersonEntity: Name: NameFull: Smith, Eileen – PersonEntity: Name: NameFull: Pullarkat, Vinod – PersonEntity: Name: NameFull: Forman, Stephen J – PersonEntity: Name: NameFull: Taplitz, Randy – PersonEntity: Name: NameFull: Nakamura, Ryotaro – PersonEntity: Name: NameFull: Malki, Monzr Al – PersonEntity: Name: NameFull: Dadwal, Sanjeet Singh IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 08 Text: Aug2024 Type: published Y: 2024 Identifiers: – Type: issn-print Value: 23288957 Numbering: – Type: volume Value: 11 – Type: issue Value: 8 Titles: – TitleFull: Open Forum Infectious Diseases Type: main |
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