Garcia-Vidal et al identified risk factors associated with an early invasive fungal infection in a recipient of a hematopoietic stem cell transplant. These can help identify a patient who may benefit from more aggressive management. The authors are from the Fred Hutchinson Cancer Research Center at the University of Washington, Oregon Health and Science University and Hospital Universitari de Bellvitge (Barcelona).
An early infection was defined as one occurring from 1 to 39 days after the transplant.
Parameters:
(1) donor
(2) HLA match
(3) antithymocyte globulin (ATG) during conditioning
(4) blood glucose level
(5) lymphocyte count
(6) serum ferritin level
(7) cytomegalovirus (CMV) infection
(8) blood transfusion
(9) corticosteroid dose
|
Parameter |
Finding |
Points |
|
donor |
related |
0 |
|
|
unrelated |
1 |
|
HLA match |
mismatched |
0 |
|
|
matched |
1 |
|
ATG during conditioning |
no |
0 |
|
|
yes |
1 |
|
glucose |
<= 200 mg/dL |
0 |
|
|
> 200 mg/dL |
1 |
|
lymphocyte count |
>= 300 per µL |
0 |
|
|
< 300 per µL |
1 |
|
serum ferritin level |
<= 2,000 ng/mL |
0 |
|
|
> 2,000 ng/mL |
1 |
|
CMV infection |
absent |
0 |
|
|
present |
1 |
|
blood transfusion |
none or few |
0 |
|
|
many |
1 |
|
corticosteroid dose |
2.0 to 2.9 mg/kg/day |
0 |
|
|
< 2.0 or >= 3.0 mg/kg/day |
1 |
number of risk factors for early mold infection =
= SUM(points for all 9 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 9
• The risk of an early mold infection increases with the number of risk factors present.
Specialty: Infectious Diseases, Surgery, general
ICD-10: ,
