Garcia-Vidal et al identified risk factors associated with invasive fungal infection by a non-Aspergillus mold in a recipient of a hematopoietic stem cell transplant. 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).
Parameters:
(1) acute graft vs host disease (GVHD)
(2) chronic graft vs host disease (GVHD)
(3) myeloablative therapy during conditioning
(4) total body irradiation (TBI) during conditioning
(5) absolute neutrophil count
(6) serum ferritin level
(7) bone marrow iron stores
(8) red blood cell transfusions
(9) corticosteroid therapy
|
Parameter |
Finding |
Points |
|
acute GVHD |
absent, Grade 1 or Grade 2 |
0 |
|
|
Grade 3 or 4 |
1 |
|
chronic GVHD |
absent or focal |
0 |
|
|
extensive |
1 |
|
myeloablative conditioning |
myeloablative |
0 |
|
|
nonmyeloablative |
1 |
|
total body irradiation |
none or low dose |
0 |
|
|
high dose |
1 |
|
absolute neutrophil count |
>= 500 per µL |
0 |
|
|
< 500 per µL (neutropenia) |
1 |
|
serum ferritin level |
<= 2,000 ng/mL |
0 |
|
|
> 2,000 ng/mL |
1 |
|
bone marrow iron status |
normal or decreased |
0 |
|
|
increased |
1 |
|
RBC transfusion |
none or few |
0 |
|
|
many |
1 |
|
corticosteroid therapy |
none or < 2 mg/kg/day |
0 |
|
|
>= 2.0 mg/kg/day |
1 |
where:
• The unadjusted hazard ratios ranged from 2.7 to 6.2.
• The p value for bone marrow iron was 0.06.
number of predictors =
= SUM(points for all 9 parameters)
Interpretation:
• minimum number of predictors: 0
• maximum number of predictors: 9
• The risk of a non-Aspergillus mold infection increases with the number of predictors present.
Specialty: Infectious Diseases, Surgery, general
ICD-10: ,
