Incidence and risk factors of invasive aspergillosis infection in patients undergoing haploidentical stem cell transplantation after prophylaxis with micafungin and oral triazole

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Incidence and risk factors of invasive aspergillosis infection in patients undergoing haploidentical stem cell transplantation after prophylaxis with micafungin and oral triazoleConference abstracts

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Aspergillus is the causative agent of human diseases ranging from asthma to invasive infection. Genetic and environmental factors are crucial in regulating the interaction between the host and Aspergillus. The role played by the enzyme indoleamine 2,3-dioxygenase 1 (IDO1), which catalyzes the first and rate-limiting step of tryptophan catabolism along the kynurenine pathway, is increasingly being recognized, but whether and how genetic variation of IDO1 influences the risk of aspergillosis in susceptible patients is incompletely understood. In addition, whether the closely related protein IDO2 plays a similar role remains …

Conclusion: This prospective multicenter study provides information on the current incidence and outcome of IFD in the real life setting. Practice variation between the centers may help to ultimately improve antifungal management in children at highest risk for IFDs.



Introduction
Available data on the incidence and outcome of invasive fungal diseases (IFD) in children treated for a hematological malignancy or undergoing allogeneic hematopoietic stem cell transplantation (HSCT) are mostly based on single site, retrospective studies or on studies performed prior to the availability of newer compounds such as broad-sp…

In this study they also showed PTX3 localized in NETs formed after neutrophil activation (5). Proteomics analysis revealed that PTX3 forms complexes with two anti-microbial proteins [azurocidin (AZU1) and myeloperoxidase (MPO)] associated to NETs (30). More recently, PTX3 localization in NETs has been confirmed, and the colocalization with AZU1 and MPO has been defined more accurately (31). Further investigation will be needed to understand the involvement of PTX3 interaction with AZU1 and MPO in their antibacterial role during NET formation.
Regulation of Complement Activation
PTX3 interaction with microorganisms is not…

We report that the bifunctional compounds enhance the interactions between primary human neutrophils and A. fumigatus in vitro, using three microfluidic assay platforms. The bifunctional compounds significantly enhance the recruitment of neutrophils, increase hyphae killing by neutrophils in a uniform concentration of drug, and decrease hyphal tip growth velocity in the presence of neutrophils compared to the antifungal targeting moiety alone. We validated that the bifunctional compounds are also effective in vivo, using a zebrafish infection model with neutrophils expressing the appropriate EM receptor. We measured signif…

Allergic bronchopulmonary aspergillosis is an immunologic pulmonary disorder caused by hypersensitivity to Aspergillus fumigatus. This disorder is most commonly seen in patients with poorly controlled asthma and cystic fibrosis. It is rarely reported in chronic granulomatous disease patients; however, there are no cases reported with hematopoietic stem cell transplantation in the English literature. Herein, we report a patient with chronic granulomatous disease who had hematopoietic stem cell transplantation and subsequently developed allergic bronchopulmonary aspergillosis.

Authors: Ceylan B, Yilmaz M, Beköz HS, Ramadan S, Ertan Akan G, Mert A
Abstract
Invasive aspergillosis is a severe infection that generally involves the lungs. Primary gastrointestinal aspergillosis is the least common form of invasive aspergillosis. A patient aged 65 years developed a febrile neutropenic episode following an autologous stem cell transplant for plasmacytoid variant diffuse large B-cell gastric non-Hodgkin’s lymphoma. He had abdominal pain on the second day of the febrile neutropenic episode and ileus occurred on the sixth day. His general condition deteriorated despite broad spectrum antibioti…

Source: Infezioni in MedicinaCategory: Infectious Diseases Tags: Infez Med Source Type: research

Authors: Kunitomi A, Hasegawa Y, Hashimoto H, Saito AM, Iida H
Abstract
Invasive fungal infections, especially those caused by Aspergillus, can be fatal in patients who have undergone allogeneic hematopoietic stem cell transplantation. Fluconazole, itraconazole and micafungin can be used to prevent fungal infections in patients undergoing allogeneic hematopoietic stem cell transplantation, but fluconazole is not effective against Aspergillus, and itraconazole has less tolerability from gastrointestinal toxicity. Micafungin is approved for prophylaxis at a dose of 50 mg/day, less than a therapeutic dose. Voriconazol…

Conclusions. ISV is widely used in hematological pts with IFI also in diseases other than acute myeloid leukemia and it is overall well tolerated. ORR to ISV is at least comparable with other antifungal agents. A rec/ref underlying hematological disease impacts both on OS and response to ISV, while having an IFI refractory to other antifungal agents including azoles does not seem to compromise the response to ISV, although this promising result should be confirmed in prospective studies and larger groups of patients.DisclosuresBusca: Gilead: Honoraria, Membership on an entity’s Board of Directors or advisory committees, Sp…

Source: BloodCategory: Hematology Authors: Tags: 203. Lymphocytes, Lymphocyte Activation, and Immunodeficiency, including HIV and Other Infections: Poster III Source Type: research

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