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http://dx.doi.org/10.4046/trd.2012.72.3.284

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)
Publication Information
Tuberculosis and Respiratory Diseases / v.72, no.3, 2012 , pp. 284-292 More about this Journal
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.
Keywords
Invasive Pulmonary Aspergillosis; Prognosis; Hematology; Mortality;
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