Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Prognosis of Invasive Pulmonary Aspergillosis in Patients with Hematologic Diseases in Korea

  • Kwon, Jae-Cheol (Division of Infectious Diseases, Department of Internal Medicine, Ilsan Hospital) ;
  • Kim, Si-Hyun (Division of Infectious Diseases, Department of Internal Medicine, The Korea University College of Medicine) ;
  • Park, Sun-Hee (Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea) ;
  • Choi, Su-Mi (Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea) ;
  • Lee, Dong-Gun (Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea) ;
  • Choi, Jung-Hyun (Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea) ;
  • Yoo, Jin-Hong (Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea) ;
  • Kim, Yoo-Jin (Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea) ;
  • Lee, Seok (Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea) ;
  • Kim, Hee-Je (Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea) ;
  • Lee, Jong-Wook (Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea) ;
  • Min, Woo-Sung (Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea)
  • Received : 2011.08.24
  • Accepted : 2011.10.31
  • Published : 2012.03.30
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Abstract

Background: The aim of this study was to investigate therapeutic outcomes and assess factors associated with therapeutic outcomes in hematologic patients with invasive pulmonary aspergillosis (IPA). Methods: We analyzed all consecutive cases of IPA in adults with hematologic diseases from January 2008 to January 2009 at a Catholic Hematopoietic Stem Cell Transplantation (HSCT) Center in Seoul, Korea. Results: A total of 54 patients were identified. Underlying diseases were acute myelogenous leukemia (n=25), acute lymphoblastic leukemia (n=10), myelodysplastic syndrome (n=7), chronic myelogenous leukemia (n=3), multiple myeloma (n=3), severe aplastic anemia (n=2) and other hematologic diseases (n=4). Twenty six patients (48.2%) were assessed as having a favorable response, of which 16 patients (29.6%) showed complete response. Overall 12-week mortality and IPA attributable mortality were 38.9% (n=21) and 33.3% (n=18), respectively. In multivariate analysis, uncontrolled underlying disease (odds ratio [OR], 7.31; 95% confidence interval [CI], 1.49~35.94; p=0.014) was associated with an unfavorable response, and for 12-week mortality, uncontrolled underlying disease (OR, 11.79; 95% CI, 1.49~93.46; p=0.020) and hypoalbuminemia (OR, 9.89; 95% CI, 1.42~68.99; p=0.021) were significantly poor prognostic factors. Conclusion: IPA still remains as a poor therapeutic outcome, especially in patients with refractory hematologic diseases.

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References

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