A new time-dependent approach for assessment of the impact of invasive aspergillosis shows effect on short- but not on long-term survival of patients with AML or high-risk MDS

Bone Marrow Transplantation
Robert J van de PeppelMark G J de Boer

Abstract

Invasive aspergillosis (IA) has been reported to yield high mortality rates. Patients with an unfavourable prognostic haematological disease not only have a higher probability of developing IA but are also more likely to die due to causes directly related to the underlying disease. This complexity of risk mechanisms confounds the causal interpretation of IA occurrence and mortality. Full consideration of the changing patient characteristics over time is necessary to obtain reliable estimates of the correlation of IA with mortality. We studied the effect of IA on mortality in 167 consecutive patients starting with remission-induction therapy for AML or of whom most patients continued to haematopoietic stem cell transplantation (HSCT). No standard antifungal prophylaxis was administered in the period before HSCT. Survival analyses were performed to determine risk estimates of IA for different phases of treatment before and after HSCT. Time-dependent adjustment for confounding variables was performed using Cox proportional hazards models. In 55 of 167 enroled patients, IA was diagnosed. Before HSCT, adjusted hazard ratios and 95% confidence intervals on mortality after the diagnosis of IA were 3.5 (1.7-7.5), 2.0 (0.69-5.9), 2.3 (0...Continue Reading

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Citations

Aug 31, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Robert J van de Peppel, Mark G J de Boer
Oct 12, 2018·Fundamental & Clinical Pharmacology·Elodie Gautier-VeyretFrançoise Stanke-Labesque
Nov 21, 2020·British Journal of Clinical Pharmacology·Elodie Gautier-VeyretFrançoise Stanke-Labesque

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