Risk factors for fungal pulmonary infections in hematopoietic stem cell transplantation recipients: the role of iron overload

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Ozyilmaz E., Aydogdu M., Sucak G., Aki S. Z., Ozkurt Z. N., Yegin Z. A., ...Daha Fazla

BONE MARROW TRANSPLANTATION, sa.10, ss.1528-1533, 2010 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2010
  • Doi Numarası: 10.1038/bmt.2009.383
  • Dergi Adı: BONE MARROW TRANSPLANTATION
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1528-1533
  • Anahtar Kelimeler: fungal pulmonary infections, hematopoietic stem cell transplantation, iron overload, sinusoidal obstruction syndrome, BONE-MARROW-TRANSPLANTATION, SINUSOIDAL OBSTRUCTION SYNDROME, INVASIVE ASPERGILLOSIS, VENOOCCLUSIVE DISEASE, SERUM FERRITIN, BOUND IRON, COMPLICATIONS, DEFIBROTIDE, LIVER, ASSOCIATION
  • Gazi Üniversitesi Adresli: Evet

Özet

Fungal pulmonary infections (FPIs) are frequent causes of mortality in hematopoietic stem cell transplantation (HSCT) recipients. Determination of the specific risk factors may improve the prognosis. The aim of this study was to evaluate the risk factors of FPIs due to HSCT. Patient history, physical examination, chest X-rays and the consultation records of the pulmonary disease department which were a part of the routine evaluation before and at first, third, sixth, ninth and twelfth months of HSCT were retrieved in 148 adult HSCT recipients. Results of the high-resolution computed tomography, fiber-optic bronchoscopy and the microbiological data were also included. FPI was diagnosed in 22 patients (14.9%). Multivariate analysis showed that increased ferritin levels (> 1000 ng/ml; OR: 3.42, 95% CI 1.03-11.42, P = 0.045) and the development of sinusoidal obstruction syndrome (SOS; OR: 5.09, 95% CI 1.53-16.90, P = 0.008) were significant risk factors for FPIs. The sensitivity and specificity of ferritin > 1000 ng/ml for the prediction of FPIs were 67 and 70%, respectively. There was a positive correlation between the increased risk of FPIs and pretransplantation ferritin levels (r = 0.413, P < 0.001) and increased ferritin levels and SOS (r = 0.331, P < 0.001). Increased pretransplantation ferritin levels and development of SOS are predictive factors of FPIs during HSCT. Bone Marrow Transplantation (2010) 45, 1528-1533; doi:10.1038/bmt.2009.383; published online 1 February 2010