COMBINATION OF INVASIVE ASPERGILLOSIS AND MUCORMYCOSIS IN ONCOHEMATOLOGICAL PATIENTS

Objective. Data analysis of the register of patients with invasive aspergillosis (IA), which was founded in Saint Petersburg (1998–2017), and clinical case description of successful treatment of IA and mucormycosis with lungs involvement in a patient with Hodgkin’s lymphoma.Materials and methods. In...

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Main Authors: O. V. Shadrivova, S. N. Khostelidi, Yu. V. Borzova, E. A. Desyatik, A. G. Volkova, M. O. Popova, O. S. Uspenskaya, O. S. Ruzhinskaya, T. V. Shneyder, T. S. Bogomolova, S. M. Ignatyeva, L. S. Zubarovskaya, B. V. Afanasyev, N. N. Klimko
Format: Article
Language:Russian
Published: ABV-press 2018-02-01
Series:Онкогематология
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Online Access:https://oncohematology.abvpress.ru/ongm/article/view/262
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author O. V. Shadrivova
S. N. Khostelidi
Yu. V. Borzova
E. A. Desyatik
A. G. Volkova
M. O. Popova
O. S. Uspenskaya
O. S. Ruzhinskaya
T. V. Shneyder
T. S. Bogomolova
S. M. Ignatyeva
L. S. Zubarovskaya
B. V. Afanasyev
N. N. Klimko
author_facet O. V. Shadrivova
S. N. Khostelidi
Yu. V. Borzova
E. A. Desyatik
A. G. Volkova
M. O. Popova
O. S. Uspenskaya
O. S. Ruzhinskaya
T. V. Shneyder
T. S. Bogomolova
S. M. Ignatyeva
L. S. Zubarovskaya
B. V. Afanasyev
N. N. Klimko
author_sort O. V. Shadrivova
collection DOAJ
description Objective. Data analysis of the register of patients with invasive aspergillosis (IA), which was founded in Saint Petersburg (1998–2017), and clinical case description of successful treatment of IA and mucormycosis with lungs involvement in a patient with Hodgkin’s lymphoma.Materials and methods. In the study were included 29 oncohematological patients with IA and mucormycosis. In control group were included 483 oncohematological patients with IA. We used criteria EORTS/MSG, 2008 for IA and mucormycosis diagnosis.Results. We identified that the combination of IA and mucormycosis significantly often develops in patients with acute lymphoblastic leukemia (32 %, р = 0.001), and allogeneic hematopoietic stem cells transplants (allo-HSCT) recipients (52 %, р = 0.001). In mixed-infection Aspergillus nidulans was frequent IA etiological agent (11 %, р = 0.001). The main mucormycosis etiological agents were Rhizopus spp. (45 %), Lichtheimia corуmbifera (20 %). The main sites of the localization were lungs (76 %), disseminated process and paranasal sinuses involvement were identified more frequently (45 % and 17 % (р = 0.0001; р = 0.002), respectively). Typical clinical feature of IA and mucormycosis combinations was hemoptysis (24 %, р = 0.008), radiological signs – lesions with cavities destruction (38 %), hydrothorax (29 %) and a “reverse halo” symptom (17 %). Antifungal therapy received 76 % of patients, surgery – 34 %.Conclusion. Mucormycosis was revealed in 5.7 % of patients with IA. The main risk factors for co-infection are allo-HSCT, long-term agranulocytosis, lymphocytopenia and glucocorticosteroid therapy. Overall 12 weeks survival in patients with mixed-infection was 38 %, significantly lower than in patients with IA (р = 0.005). An unfavorable prognosis factor was dissemination of mycotic infection (р = 0.009).
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spelling doaj-art-436f6dc073e3410281dcb8045e9d15fd2025-08-20T03:21:28ZrusABV-pressОнкогематология1818-83462413-40232018-02-0112481710.17650/1818-8346-2017-12-4-8-17249COMBINATION OF INVASIVE ASPERGILLOSIS AND MUCORMYCOSIS IN ONCOHEMATOLOGICAL PATIENTSO. V. Shadrivova0S. N. Khostelidi1Yu. V. Borzova2E. A. Desyatik3A. G. Volkova4M. O. Popova5O. S. Uspenskaya6O. S. Ruzhinskaya7T. V. Shneyder8T. S. Bogomolova9S. M. Ignatyeva10L. S. Zubarovskaya11B. V. Afanasyev12N. N. Klimko13I.I. Mechnikov North-Western State Medical UniversityI.I. Mechnikov North-Western State Medical UniversityI.I. Mechnikov North-Western State Medical UniversityI.I. Mechnikov North-Western State Medical UniversityI.P. Pavlov First Saint Petersburg State Medical UniversityI.P. Pavlov First Saint Petersburg State Medical UniversityLeningrad Regional Clinical HospitalI.P. Pavlov First Saint Petersburg State Medical UniversityLeningrad Regional Clinical HospitalI.I. Mechnikov North-Western State Medical UniversityI.I. Mechnikov North-Western State Medical UniversityI.P. Pavlov First Saint Petersburg State Medical UniversityI.P. Pavlov First Saint Petersburg State Medical UniversityI.I. Mechnikov North-Western State Medical UniversityObjective. Data analysis of the register of patients with invasive aspergillosis (IA), which was founded in Saint Petersburg (1998–2017), and clinical case description of successful treatment of IA and mucormycosis with lungs involvement in a patient with Hodgkin’s lymphoma.Materials and methods. In the study were included 29 oncohematological patients with IA and mucormycosis. In control group were included 483 oncohematological patients with IA. We used criteria EORTS/MSG, 2008 for IA and mucormycosis diagnosis.Results. We identified that the combination of IA and mucormycosis significantly often develops in patients with acute lymphoblastic leukemia (32 %, р = 0.001), and allogeneic hematopoietic stem cells transplants (allo-HSCT) recipients (52 %, р = 0.001). In mixed-infection Aspergillus nidulans was frequent IA etiological agent (11 %, р = 0.001). The main mucormycosis etiological agents were Rhizopus spp. (45 %), Lichtheimia corуmbifera (20 %). The main sites of the localization were lungs (76 %), disseminated process and paranasal sinuses involvement were identified more frequently (45 % and 17 % (р = 0.0001; р = 0.002), respectively). Typical clinical feature of IA and mucormycosis combinations was hemoptysis (24 %, р = 0.008), radiological signs – lesions with cavities destruction (38 %), hydrothorax (29 %) and a “reverse halo” symptom (17 %). Antifungal therapy received 76 % of patients, surgery – 34 %.Conclusion. Mucormycosis was revealed in 5.7 % of patients with IA. The main risk factors for co-infection are allo-HSCT, long-term agranulocytosis, lymphocytopenia and glucocorticosteroid therapy. Overall 12 weeks survival in patients with mixed-infection was 38 %, significantly lower than in patients with IA (р = 0.005). An unfavorable prognosis factor was dissemination of mycotic infection (р = 0.009).https://oncohematology.abvpress.ru/ongm/article/view/262invasive aspergillosismucormycosisaspergillusrhizopuslichtheimia corуmbiferarhizomucor
spellingShingle O. V. Shadrivova
S. N. Khostelidi
Yu. V. Borzova
E. A. Desyatik
A. G. Volkova
M. O. Popova
O. S. Uspenskaya
O. S. Ruzhinskaya
T. V. Shneyder
T. S. Bogomolova
S. M. Ignatyeva
L. S. Zubarovskaya
B. V. Afanasyev
N. N. Klimko
COMBINATION OF INVASIVE ASPERGILLOSIS AND MUCORMYCOSIS IN ONCOHEMATOLOGICAL PATIENTS
Онкогематология
invasive aspergillosis
mucormycosis
aspergillus
rhizopus
lichtheimia corуmbifera
rhizomucor
title COMBINATION OF INVASIVE ASPERGILLOSIS AND MUCORMYCOSIS IN ONCOHEMATOLOGICAL PATIENTS
title_full COMBINATION OF INVASIVE ASPERGILLOSIS AND MUCORMYCOSIS IN ONCOHEMATOLOGICAL PATIENTS
title_fullStr COMBINATION OF INVASIVE ASPERGILLOSIS AND MUCORMYCOSIS IN ONCOHEMATOLOGICAL PATIENTS
title_full_unstemmed COMBINATION OF INVASIVE ASPERGILLOSIS AND MUCORMYCOSIS IN ONCOHEMATOLOGICAL PATIENTS
title_short COMBINATION OF INVASIVE ASPERGILLOSIS AND MUCORMYCOSIS IN ONCOHEMATOLOGICAL PATIENTS
title_sort combination of invasive aspergillosis and mucormycosis in oncohematological patients
topic invasive aspergillosis
mucormycosis
aspergillus
rhizopus
lichtheimia corуmbifera
rhizomucor
url https://oncohematology.abvpress.ru/ongm/article/view/262
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