Evidence map›Paper›PMID 41004247›Full record

Observational studyTransplant infectious disease : an official journal of the Transplantation Society

The Changing Epidemiology of Breakthrough Invasive Fungal Disease in Allogeneic Hematopoietic Stem Cell Transplant Recipients in the Era of Modified-Release Posaconazole Prophylaxis.

Shio Yen Tio, Chin Fen Neoh, David Ritchie, Lynette Chee, David C M Kong, Leon J Worth, Michelle K Yong, Monica A Slavin

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Transplant infectious disease : an official journal of the Transplantation Society. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Observational
  2. Review
  3. Observational
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Shio Yen TioDepartment of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.ORCID https://orcid.org/0000-0002-2774-2237
Chin Fen NeohDepartment of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.
David RitchieDepartment of Clinical Haematology, Peter Maccallum Cancer Centre, The Royal Melbourne Hospital, Melbourne, Australia.
Lynette CheeDepartment of Clinical Haematology, Peter Maccallum Cancer Centre, The Royal Melbourne Hospital, Melbourne, Australia.
David C M KongNational Centre For Infections in Cancer, Melbourne, Australia.
Leon J WorthDepartment of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.
Michelle K YongDepartment of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.
Monica A SlavinDepartment of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.

Funding

MSD Australia
6 · The paper itself

Abstract

backgroundAllogeneic hemopoietic stem cell transplant (aHSCT) recipients are at high-risk for invasive fungal disease (IFD), even with mould-active antifungal prophylaxis (AFP).

methodsThis was a retrospective, observational, single-center cohort study involving 300 adult aHSCT recipients transplanted from January 2017-May 2020. Patient demographics, underlying hematological malignancy (HM), transplant characteristics and AFP were described. The primary objectives were rate and characteristics of breakthrough IFD (bIFD) within 1-year post-transplant.

resultsOf 300 aHSCT recipients, 195 (65%) were males; median age at transplantation was 54 years (IQR 43-62). Acute leukemia was the most common underlying HM (50%), and modified-release posaconazole was the main primary AFP (88%). B-IFD occurred in 26 patients (9%): 14 breakthrough invasive mould diseases (bIMD), which Aspergillus species predominated (56%), followed by Lomentospora prolificans (31%); and 12 breakthrough invasive yeast infections, with Nakaseomyces glabratus most frequently isolated. Neither Aspergillus fumigatus complex nor Candida albicans was cultured as breakthrough organisms. bIMD occurred late post aHSCT at median of 167 days, whereas breakthrough invasive yeast infection occurred at median of 21 days. Twelve patients (46%) had therapeutic-drug-monitoring at time of bIFD-all were within therapeutic range. All-cause mortality at 12-weeks from bIMD and breakthrough invasive yeast infection infections were 50% and 58%, respectively.

conclusionAlthough bIFD rate was consistent with other reports, mortality after bIFD remained significant. Use of mould-active AFP likely explained the changing epidemiology of fungal isolates. Resistant breakthrough fungal organisms, especially L. prolificans, reflected local epidemiology. Ongoing surveillance of IFD including resistant organisms is warranted to optimize treatment and patient outcome.

Indexed as

Antifungal AgentsHematopoietic Stem Cell TransplantationInvasive Fungal InfectionsTriazolesAdultFemaleHematologic NeoplasmsHumansMaleMiddle AgedRetrospective StudiesTransplantation, HomologousTransplant RecipientsAntifungal AgentsposaconazoleTriazolesallogeneic hematopoietic stem cell transplantbreakthrough invasive fungal diseaseinvasive mould diseaseinvasive yeast infectionsposaconazole prophylaxis

Identifiers

PMID41004247
PMCPMC12793966

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.