The Journal of infection · 2025
Risk factors for invasive mould infections in adult patients with hematological malignancies and/or stem cell transplant: A systematic literature review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Gras Emmanuelle, Azoyan Loris, Monzo-Gallo Patricia, Garcia-Vidal Carolina, Lanternier Fanny, Brissot Eolia, Guitard Juliette, Lacombe Karine, Dechartres Agnès, Surgers Laure
Аннотация
OBJECTIVES: To evaluate risk factors for invasive mould infections (IMI) in adult patients with hematological malignancies and/or hematopoietic stem cell transplantation (HSCT).
METHODS: Systematic review from PubMed, Embase, CENTRAL, and grey literature (01/01/2002-23/01/2025). Eligible studies were cohort or case-control studies. Selection, data extraction, and bias assessment were performed in duplicate. Adjusted measure effects were pooled using random-effects models.
RESULTS: From 13,372 references, 45 studies were included; 17 focused on any type of IMI (n=846), 26 specifically on invasive aspergillosis (IA, n=2086) and 2 on mucormycosis (n=53). Twenty-eight studies (10 on IMI, 18 on IA) were eligible for meta-analysis. Relapsed/refractory hemopathies were significantly associated with a higher risk of IMI (HR 3.43 [95%CI 1.58-7.46]) whereas prolonged neutropenia was associated with IA (OR 4.85 [95%CI 2.15-10.97]). Specifically in the allo-HSCT population, both acute and chronic graft vs host disease (GvHD) (acute GvHD HR 3.23 [95%CI 2.20-4.74]; chronic GvHD HR 2.95 [95%CI 1.25-6.96]) were associated with IMI and CMV disease (HR 3.23 [95%CI 1.00-10.43]), and corticosteroid use (HR 4.67 [95% CI 2.79-7.82]) were associated with IA.
CONCLUSION: Recognizing risk factors for IMI in patients with hematological malignancy or HSCT is essential to improve prevention and management strategies.
REGISTRATION: PROSPERO, CRD42023429103.
METHODS: Systematic review from PubMed, Embase, CENTRAL, and grey literature (01/01/2002-23/01/2025). Eligible studies were cohort or case-control studies. Selection, data extraction, and bias assessment were performed in duplicate. Adjusted measure effects were pooled using random-effects models.
RESULTS: From 13,372 references, 45 studies were included; 17 focused on any type of IMI (n=846), 26 specifically on invasive aspergillosis (IA, n=2086) and 2 on mucormycosis (n=53). Twenty-eight studies (10 on IMI, 18 on IA) were eligible for meta-analysis. Relapsed/refractory hemopathies were significantly associated with a higher risk of IMI (HR 3.43 [95%CI 1.58-7.46]) whereas prolonged neutropenia was associated with IA (OR 4.85 [95%CI 2.15-10.97]). Specifically in the allo-HSCT population, both acute and chronic graft vs host disease (GvHD) (acute GvHD HR 3.23 [95%CI 2.20-4.74]; chronic GvHD HR 2.95 [95%CI 1.25-6.96]) were associated with IMI and CMV disease (HR 3.23 [95%CI 1.00-10.43]), and corticosteroid use (HR 4.67 [95% CI 2.79-7.82]) were associated with IA.
CONCLUSION: Recognizing risk factors for IMI in patients with hematological malignancy or HSCT is essential to improve prevention and management strategies.
REGISTRATION: PROSPERO, CRD42023429103.