INCIDENCE AND RISK-FACTORS FOR INVASIVE FUNGAL-INFECTIONS IN ALLOGENEIC BMT RECIPIENTS

In order to analyze the incidence and risk factors for invasive fungal infection (IFI) after allogeneic BMT, 142 consecutive adult BMT recip ients (131 sibling donors, 11 unrelated donors) transplanted in 1989-1 993 were retrospectively analyzed. There were 21 cases with definite o r probable IFI (incidence 15%) (Aspergillus, 15; Candida, four; Fusari um, one; Absidia, one), The median time to the diagnosis of IFI was 13 6 days after BMT (range 6-466 days), Only 14% of the IFIs were found d uring the neutropenic period post-BMT. Of the pretransplant characteri stics, hematological disease (MDS vs other) (P = 0.001) and unrelated donor (P = 0.01) were risk factors for IFI, Acute GVHD grade III-IV (P = 0.03) and extensive chronic GVHD (P = 0.0002) were also found to be significant risk factors, Only three patients with IFI (14%) became l ong-term survivors, Invasive fungal infections tended to develop late after BMT, were usually caused by Aspergillus sp,, and were strongly a ssociated with GVHD and its treatment, Better prophylaxis and treatmen t of IFI are needed, More effective prophylaxis for GVHD might decreas e the risk of IFI after allogeneic BMT.