OBJECTIVE:To study the incidence, risk factors and outcome of invasive fungal infection(IFI) in the recipients with allogeneic hematopoietic cell transplantation(HSCT).METHODS:79 cases received HSCT in our hospital from January 2005 to November 2014 with complete data were analyzed retrospectively according to the diagnostic criteria of IFI. the clinical features, risk factors and outcome of IFI were investigated and analysed.RESULTS:17 cases of IFI were diagnosed, among them 13 cases were defined in clinic and 4 cases were possible. The median time of IFI occurence was 112 days(9-1931 d). The recurrence-free survival rate in non-infection and infection groups were 61.2% and 35.2% respectively. By single-factor analysis, the matching, II and IV degree of aGVHD were the risk factors of IFI, and the sex, protopathy, glucocorticoid used before infection were the risk factors of the death outcome. Multivariate analysis may indicated that the matching, II-IV degree of aGVHD and glucocorticoid used before infection were associated with IFI and outcome.CONCLUSION:The patients received HSCT and having many risk factors are more likely predisposed to IFI. A greater dose of glucocorticoid used before infection is more likely to results in death, morever avoiding the risk factors may reduce the incidence of IFI, and the retrospecion of immunosupperssor dose used within 30 days before infection may improve prognosis.

Abstract To analysis the cytomegalovirus（CMV） infection rate and median time which the CMV-DNA was positive for the first time. Simultaneously, to demonstrete the risk factors associated with CMV infection and CMV disease distribution and mortality after allogeneic hematopoietic stem cell transplantation（allo-HSCT).A retrospective study among 108 patients with allogeneic hematopoietic stem cell transplantation allogeneic hematopoietic stem cell transplantation(allo-HSCT) was conducted during 1st Jan 2004 and 31stMar 2014 in Zhongda hospital.The infection rate of CMV was 52.78%(57/108), the median time of CMV infection was 44d, especially during 30d~100d. The univariate analysis showed that CMV infection rate was associated with the HLA-identical situation between the donor and recipient, whether the use of Anti-human thymus globulin(ATG) conditioning regimen, neutropenic period after transplantation exceeded 10d and graft-versus-host disease (GVHD). Multivariate analysis showed that CMV infection rate was associated with neutropenic period after transplantation which exceeded 10d and graft-versus-host disease (GVHD).The mortality of the patients who had CMV infection was 10/17 and the mortality of CMV interstitial pneumonia was higher. CMV infection was one of the most commonly happened infection after allo-HSCT. To reduce the incidence of CMV disease and mortality, the best choice of Allo-HSCT was HLA-identical donor, ATG should be used during the process, and neutropenic period should be reduced less than 10 days. Moreover, it is necessary to strengthen the treatment of CMV infection actively. Disclosures No relevant conflicts of interest to declare.

This study was purposed to investigate the cytomegalovirus (CMV) infection and its related factors after allogenic hematopoietic stem cell transplantation (allo-HSCT). A total of 108 patients who received allo-HSCT in zhongda hospital from January 1, 2004 to March 31, 2014 were enrolled in this study. The CMV infection rate and the median time when the CMV-DNA was positive for the first time, and the risk factors related with CMV infection, CMV disease distribution and mortality after allo-HSCT were analyzed. The results showed that the infection rate of CMV was 52.78% (57/108), the median time of CMV infection was 44 d, especially during 30 d-100 d after transplantation. The univariate analysis showed that CMV infection rate was related with the HLA-identical situation between the donor and the recipient, and whether the use of anti-human thymus globulin(ATG) in conditioning regimen, neutropenic period after transplantation exceeded 10 d and graft-versus-host disease (GVHD). Multivariate analysis showed that CMV infection rate was related with neutropenic period longer than 10 d after transplantation and graft-versus-host disease (GVHD). The mortality of the patients with CMV disease was 58.82% (10/17), in which the mortality of CMV interstitial pneumonia was highest. The CMV infection was one of the most commonly happened infection after allo-HSCT. It is concluded that to reduce the incidence of CMV disease and mortality, the best choice of allo-HSCT is HLA-identical donor, ATG should be used during the conditioning process, and neutropenic period should be reduced less than 10 days. Moreover, it is necessary to strengthen the preemptive therapy of CMV infection actively.