Risk factors for invasive fungal infections in adult patients with hematological malignancies and/or stem cell transplant: a systematic review and meta-analysis
Abstract Improving prevention and treatment strategies for invasive fungal infections (IFI) is essential to reduce associated morbidity and mortality. We performed a systematic review and meta-analyses to assess factors associated with IFI in adult patients with hematological malignancies and/or hem...
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Nature Portfolio
2025-08-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-16066-6 |
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| author | Emmanuelle Gras Patricia Monzo-Gallo Loris Azoyan Carolina Garcia-Vidal Fanny Lanternier Eolia Brissot Juliette Guitard Karine Lacombe Agnès Dechartres Laure Surgers |
| author_facet | Emmanuelle Gras Patricia Monzo-Gallo Loris Azoyan Carolina Garcia-Vidal Fanny Lanternier Eolia Brissot Juliette Guitard Karine Lacombe Agnès Dechartres Laure Surgers |
| author_sort | Emmanuelle Gras |
| collection | DOAJ |
| description | Abstract Improving prevention and treatment strategies for invasive fungal infections (IFI) is essential to reduce associated morbidity and mortality. We performed a systematic review and meta-analyses to assess factors associated with IFI in adult patients with hematological malignancies and/or hematopoietic stem cell transplantation (HSCT). Data sources. We searched PubMed, Embase, CENTRAL and the grey literature from 01/01/2002 to 08/02/2024. Study eligibility criteria. Eligible studies were case-control or cohort studies including adult patients with hematological malignancies and/or HSCT and reporting risk factors for IFI. Participants. Adult patients with hematological malignancies and/or HSCT. Assessment of risk of bias. Risk of bias assessment was assessed independently using the Critical Appraisal Skills Programme checklists for cohort studies and case-control studies. Methods of data synthesis. Study selection and data extraction were done independently. Adjusted estimates were pooled using random effects models. Among 12 624 references identified, 69 studies (reporting 2917 IFI) were included in the systematic review, 20 of which were included in meta-analyses. Factors independently associated with IFI included previous allo-HSCT (pooled aHR 3.21 [95%CI 1.54–6.71]), especially with a haploidentical donor (pooled aHR 2.41 [95%CI 1.27–4.57]), acute graft vs. host disease (aGvHD) ≥ 2 (pooled aHR 2.59 [95%CI 1.36–4.90]), corticosteroids (pooled aOR 2.84 [95%CI 1.42–5.70]) or T-cell depleting agents (pooled aOR 2.73 [95%CI 1.61–4.64]). Antifungal prophylaxis was a protective factor for IFI (pooled aOR 0.20 [95%CI 0.13–0.28]). The identification of factors independently associated with IFI may help to stratify IFI risk among hematological patients. Registration: PROSPERO, CRD42023429103. |
| format | Article |
| id | doaj-art-389acc313c72426cbb44fbcec8ab5117 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-389acc313c72426cbb44fbcec8ab51172025-08-24T11:25:08ZengNature PortfolioScientific Reports2045-23222025-08-0115111110.1038/s41598-025-16066-6Risk factors for invasive fungal infections in adult patients with hematological malignancies and/or stem cell transplant: a systematic review and meta-analysisEmmanuelle Gras0Patricia Monzo-Gallo1Loris Azoyan2Carolina Garcia-Vidal3Fanny Lanternier4Eolia Brissot5Juliette Guitard6Karine Lacombe7Agnès Dechartres8Laure Surgers9Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé PubliqueDepartment of Infectious Diseases, Hospital Clinic of Barcelona, IDIBAPSSorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé PubliqueDepartment of Infectious Diseases, Hospital Clinic of Barcelona, IDIBAPSNational Reference Center for Invasives Mycoses and Antifungals, Mycology Department, Institut Pasteur, Paris Cité UniversityService d’ Hématologie Clinique et Thérapie Cellulaire, GHU AP-HP. Sorbonne Université, Hôpital Saint-AntoineLaboratoire de parasitologie-Mycologie, Iserm, Sorbonne University, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint-AntoineSorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé PubliqueDépartement de Santé Publique, Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Centre de Pharmacoépidémiologie de l’AP-HP (Cephepi)Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé PubliqueAbstract Improving prevention and treatment strategies for invasive fungal infections (IFI) is essential to reduce associated morbidity and mortality. We performed a systematic review and meta-analyses to assess factors associated with IFI in adult patients with hematological malignancies and/or hematopoietic stem cell transplantation (HSCT). Data sources. We searched PubMed, Embase, CENTRAL and the grey literature from 01/01/2002 to 08/02/2024. Study eligibility criteria. Eligible studies were case-control or cohort studies including adult patients with hematological malignancies and/or HSCT and reporting risk factors for IFI. Participants. Adult patients with hematological malignancies and/or HSCT. Assessment of risk of bias. Risk of bias assessment was assessed independently using the Critical Appraisal Skills Programme checklists for cohort studies and case-control studies. Methods of data synthesis. Study selection and data extraction were done independently. Adjusted estimates were pooled using random effects models. Among 12 624 references identified, 69 studies (reporting 2917 IFI) were included in the systematic review, 20 of which were included in meta-analyses. Factors independently associated with IFI included previous allo-HSCT (pooled aHR 3.21 [95%CI 1.54–6.71]), especially with a haploidentical donor (pooled aHR 2.41 [95%CI 1.27–4.57]), acute graft vs. host disease (aGvHD) ≥ 2 (pooled aHR 2.59 [95%CI 1.36–4.90]), corticosteroids (pooled aOR 2.84 [95%CI 1.42–5.70]) or T-cell depleting agents (pooled aOR 2.73 [95%CI 1.61–4.64]). Antifungal prophylaxis was a protective factor for IFI (pooled aOR 0.20 [95%CI 0.13–0.28]). The identification of factors independently associated with IFI may help to stratify IFI risk among hematological patients. Registration: PROSPERO, CRD42023429103.https://doi.org/10.1038/s41598-025-16066-6Invasive fungal infectionHematological malignancyHematogenous stem cell transplantationSystematic reviewRisk factors |
| spellingShingle | Emmanuelle Gras Patricia Monzo-Gallo Loris Azoyan Carolina Garcia-Vidal Fanny Lanternier Eolia Brissot Juliette Guitard Karine Lacombe Agnès Dechartres Laure Surgers Risk factors for invasive fungal infections in adult patients with hematological malignancies and/or stem cell transplant: a systematic review and meta-analysis Scientific Reports Invasive fungal infection Hematological malignancy Hematogenous stem cell transplantation Systematic review Risk factors |
| title | Risk factors for invasive fungal infections in adult patients with hematological malignancies and/or stem cell transplant: a systematic review and meta-analysis |
| title_full | Risk factors for invasive fungal infections in adult patients with hematological malignancies and/or stem cell transplant: a systematic review and meta-analysis |
| title_fullStr | Risk factors for invasive fungal infections in adult patients with hematological malignancies and/or stem cell transplant: a systematic review and meta-analysis |
| title_full_unstemmed | Risk factors for invasive fungal infections in adult patients with hematological malignancies and/or stem cell transplant: a systematic review and meta-analysis |
| title_short | Risk factors for invasive fungal infections in adult patients with hematological malignancies and/or stem cell transplant: a systematic review and meta-analysis |
| title_sort | risk factors for invasive fungal infections in adult patients with hematological malignancies and or stem cell transplant a systematic review and meta analysis |
| topic | Invasive fungal infection Hematological malignancy Hematogenous stem cell transplantation Systematic review Risk factors |
| url | https://doi.org/10.1038/s41598-025-16066-6 |
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