Risk factors for invasive mould infections in adult patients with hematological malignancies and/or stem cell transplant: A systematic literature review and meta-analysis

IF 11.9 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection Pub Date : 2025-08-11 DOI:10.1016/j.jinf.2025.106574

Emmanuelle Gras , Loris Azoyan , Patricia Monzo-Gallo , Carolina Garcia-Vidal , Fanny Lanternier , Eolia Brissot , Juliette Guitard , Karine Lacombe , Agnès Dechartres , Laure Surgers

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引用次数: 0

Abstract

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.

查看原文本刊更多论文

成人血液恶性肿瘤和/或干细胞移植患者侵袭性霉菌感染的危险因素：系统文献综述和荟萃分析

目的：评估血液学恶性肿瘤和/或造血干细胞移植（HSCT）成人患者侵袭性霉菌感染（IMI）的危险因素。方法：系统回顾PubMed、Embase、CENTRAL和灰色文献（2002年1月1日- 2025年1月23日）。符合条件的研究为队列研究或病例对照研究。选择、数据提取和偏倚评估一式两份进行。采用随机效应模型合并调整后的测量效应。结果：从13372篇文献中，纳入45篇研究；17例针对任何类型的IMI (n=846)， 26例针对侵袭性曲霉病（IA, n= 2086）， 2例针对毛霉病（n=53）。28项研究（10项关于IMI， 18项关于IA）符合meta分析。复发/难治性血液病与较高的IMI风险显著相关（HR 3.43 [95%CI 1.58-7.46]），而长期中性粒细胞减少与IA相关（OR 4.85 [95%CI 2.15-10.97]）。特别是在同种异体造血干细胞移植人群中，急性和慢性移植物抗宿主病（GvHD）(急性GvHD HR 3.23 [95%CI 2.20-4.74]；慢性GvHD （HR 2.95 [95% ci 1.25-6.96]）与IMI和CMV疾病相关（HR 3.23 [95% ci 1.00-10.43]），皮质类固醇使用（HR 4.67 [95% CI2.79-7.82]）与IA相关。结论：认识血液恶性肿瘤或造血干细胞移植患者IMI的危险因素对改善预防和管理策略至关重要。

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来源期刊

Journal of Infection 医学-传染病学

CiteScore

45.90

自引率

3.20%

发文量

475

审稿时长

16 days

期刊介绍： The Journal of Infection publishes original papers on all aspects of infection - clinical, microbiological and epidemiological. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in the ever-changing field of infection. Each issue brings you Editorials that describe current or controversial topics of interest, high quality Reviews to keep you in touch with the latest developments in specific fields of interest, an Epidemiology section reporting studies in the hospital and the general community, and a lively correspondence section.