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Gavriilaki E, Dolgyras P, Dimou-Mpesikli S, Poulopoulou A, Evangelidis P, Evangelidis N, Demosthenous C, Zachrou E, Siasios P, Mallouri D, Vardi A, Bousiou Z, Panteliadou A, Batsis I, Masmanidou M, Lalayanni C, Yannaki E, Sotiropoulos D, Anagnostopoulos A, Vyzantiadis TA, Sakellari I. Risk Factors, Prevalence, and Outcomes of Invasive Fungal Disease Post Hematopoietic Cell Transplantation and Cellular Therapies: A Retrospective Monocenter Real-Life Analysis. Cancers (Basel) 2023; 15:3529. [PMID: 37444639 DOI: 10.3390/cancers15133529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: Autologous, allogeneic hematopoietic cell transplantation (HCT) and other cellular therapies, including CAR T cell and gene therapy, constitute a cornerstone in the management of various benign and malignant hematological disorders. Invasive fungal infections (IFD) remain a significant cause of morbidity and mortality in HCT recipients. Therefore, we investigated the prevalence and risk factors of IFD following HCT and other cellular therapies in an era of novel antifungal prophylaxis. (2) Methods: In this study, we retrospectively enrolled adult HCT recipients who were treated at our JACIE-accredited center according to standard operating procedures over the last decade (2013-2022). (3) Results: 950 patients who received cellular therapies were studied. None of the 19 CAR T cell and neither of the two gene therapy recipients developed IFD whereas 3/456 autologous HCT recipients who suffered from primary refractory/relapsed lymphomas presented with probable IFD. Overall, 11 patients who received allogeneic HCT experienced probable IFD, possible IFD was found in 31/473, and IFD was proven in 10/473. A second IFD episode was present in three patients. Four-year OS was significantly lower in proven compared to probable IFD (p = 0.041) and was independently associated with HCT-CI (p = 0.040) and chronic GVHD (p = 0.045). (4) Conclusions: In this real-world cohort, the prevalence of proven and probable IFD in an era of novel antifungal prophylaxis was found to be relatively low. However, IFDs were associated with poor outcomes for patients who received allogeneic HCT.
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Affiliation(s)
- Eleni Gavriilaki
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Panagiotis Dolgyras
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Sotiria Dimou-Mpesikli
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Aikaterini Poulopoulou
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Paschalis Evangelidis
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Nikolaos Evangelidis
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Christos Demosthenous
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Evangelia Zachrou
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Panagiotis Siasios
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Despina Mallouri
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Anna Vardi
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Zoi Bousiou
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Alkistis Panteliadou
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Ioannis Batsis
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Marianna Masmanidou
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Chrysavgi Lalayanni
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Evangelia Yannaki
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Damianos Sotiropoulos
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Achilles Anagnostopoulos
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | | | - Ioanna Sakellari
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
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Siasios P, Arvaniti K, Zachrou E, Poulopoulou A, Pisanidou P, Vasileiadou G, Kaimakamis E, Georgopoulou A, Renta F, Lathyris D, Veroniki F, Geka E, Soultati I, Argiriadou E, Apostolidou E, Amoiridou P, Ioannou K, Kouras L, Mimitou I, Stokkos K, Flioni E, Pertsas E, Sileli M, Iasonidou C, Sourla E, Pitsiou G, Vyzantiadis TA. COVID-19-Associated Pulmonary Aspergillosis (CAPA) in Northern Greece during 2020-2022: A Comparative Study According to the Main Consensus Criteria and Definitions. J Fungi (Basel) 2023; 9:jof9010081. [PMID: 36675902 PMCID: PMC9863007 DOI: 10.3390/jof9010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/01/2023] [Accepted: 01/03/2023] [Indexed: 01/07/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) has emerged as an important complication among patients with acute respiratory failure due to SARS-CoV-2 infection. Almost 2.5 years since the start of the COVID-19 pandemic, it continues to raise concerns as an extra factor that contributes to increased mortality, which is mostly because its diagnosis and management remain challenging. The present study utilises the cases of forty-three patients hospitalised between August 2020 and February 2022 whose information was gathered from ten ICUs and special care units based in northern Greece. The main aim was to describe the gained experience in diagnosing CAPA, according to the implementation of the main existing diagnostic consensus criteria and definitions, and present the different classification of the clinical cases due to the alternative algorithms.
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Affiliation(s)
- Panagiotis Siasios
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence:
| | - Kostoula Arvaniti
- ICU, “Papageorgiou” General Hospital of Thessaloniki, 56403 Thessaloniki, Greece
| | - Evangelia Zachrou
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Aikaterini Poulopoulou
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Pinelopi Pisanidou
- ICU, “Papageorgiou” General Hospital of Thessaloniki, 56403 Thessaloniki, Greece
| | - Georgia Vasileiadou
- First ICU, “G. Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
| | - Evangelos Kaimakamis
- First ICU, “G. Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
| | - Athina Georgopoulou
- First ICU, “G. Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
| | - Foteini Renta
- ICU, “G. Gennimatas” General Hospital of Thessaloniki, 54635 Thessaloniki, Greece
| | - Dimitrios Lathyris
- ICU, “G. Gennimatas” General Hospital of Thessaloniki, 54635 Thessaloniki, Greece
| | - Foteini Veroniki
- First ICU, “AHEPA” University General Hospital of Thessaloniki, 54636 Thessaloniki, Greece
| | - Eleni Geka
- First ICU, “AHEPA” University General Hospital of Thessaloniki, 54636 Thessaloniki, Greece
| | - Ioanna Soultati
- Second ICU, “AHEPA” University General Hospital of Thessaloniki, 54636 Thessaloniki, Greece
| | - Eleni Argiriadou
- Second ICU, “AHEPA” University General Hospital of Thessaloniki, 54636 Thessaloniki, Greece
| | - Eleni Apostolidou
- ICU, “Bodossakio” General Hospital of Ptolemaida, 50200 Ptolemaida, Greece
| | - Pinelopi Amoiridou
- ICU, “Bodossakio” General Hospital of Ptolemaida, 50200 Ptolemaida, Greece
| | | | - Leonidas Kouras
- ICU, “Mamatsio” General Hospital of Kozani, 50100 Kozani, Greece
| | - Ioanna Mimitou
- ICU, “Mamatsio” General Hospital of Kozani, 50100 Kozani, Greece
| | | | - Elliniki Flioni
- ICU, “Agios Pavlos” General Hospital of Thessaloniki, 55134 Thessaloniki, Greece
| | - Evangelos Pertsas
- ICU, “Agios Pavlos” General Hospital of Thessaloniki, 55134 Thessaloniki, Greece
| | - Maria Sileli
- Second ICU, “G. Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
| | - Christina Iasonidou
- Second ICU, “G. Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
| | - Evdokia Sourla
- Respiratory Failure Unit, “G. Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
| | - Georgia Pitsiou
- Respiratory Failure Unit, “G. Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
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