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. 2023 Jul 7;15(13):3529.
doi: 10.3390/cancers15133529.

Risk Factors, Prevalence, and Outcomes of Invasive Fungal Disease Post Hematopoietic Cell Transplantation and Cellular Therapies: A Retrospective Monocenter Real-Life Analysis

Eleni Gavriilaki  1   2 , Panagiotis Dolgyras  1 , Sotiria Dimou-Mpesikli  1 , Aikaterini Poulopoulou  3 , Paschalis Evangelidis  2 , Nikolaos Evangelidis  2 , Christos Demosthenous  1 , Evangelia Zachrou  3 , Panagiotis Siasios  3 , Despina Mallouri  1 , Anna Vardi  1 , Zoi Bousiou  1 , Alkistis Panteliadou  1 , Ioannis Batsis  1 , Marianna Masmanidou  1 , Chrysavgi Lalayanni  1 , Evangelia Yannaki  1 , Damianos Sotiropoulos  1 , Achilles Anagnostopoulos  1 , Timoleon-Achilleas Vyzantiadis  3 , Ioanna Sakellari  1
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Risk Factors, Prevalence, and Outcomes of Invasive Fungal Disease Post Hematopoietic Cell Transplantation and Cellular Therapies: A Retrospective Monocenter Real-Life Analysis

Eleni Gavriilaki et al. Cancers (Basel). .

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.

Keywords: CAR T cell therapy; antifungal; hematopoietic cell transplantation (HCT); immunosuppression; invasive fungal infection; mold; prophylaxis; risk factors; yeast.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Impact of IFD post-alloHCT on overall survival (OS). Any type of ΙFD associates with lower OS.
See this image and copyright information in PMC

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