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KMID : 0383820120720030284
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Tuberculosis and Respiratory Diseases
2012 Volume.72 No. 3 p.284 ~ p.292
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Prognosis of Invasive Pulmonary Aspergillosis in Patients with Hematologic Diseases in Korea
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Kwon Jae-Cheol
Kim Si-Hyun
Park Sun-Hee
Choi Su-Mi
Lee Dong-Gun
Choi Jung-Hyun
Yoo Jin-Hong
Kim Yoo-Jin
Lee Seok
Kim Hee-Je
Lee Jong-Wook
Min Woo-Sung
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Abstract
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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).
Materials and 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.
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KEYWORD
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Invasive Pulmonary Aspergillosis, Prognosis, Hematology, Mortality
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