Clinical characteristics of patients with evidence of invasive aspergillosis
| Patient . | Disease . | Treatment modality . | GVHD grade . | Pred, mg/kg . | Neutropenia less than 500/μL, d . | SI . | IFN-γ, pg/mL . | IL-10, pg/mL . | Ratio IFN-γ/IL-10 . | Clinical sites of IA . | Aspergillus species . | Pathology . | Response* . |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patients with proven/probable invasive aspergillosis | |||||||||||||
| 1 | CLL | Allo PBSCT | II | 0 | 16 | 18.5 | 77.3 | 37.5 | 2.1 | Lung | UD | Septate branched hyphae (lung) | Stable |
| 2 | CML | Allo PBSCT | II | 1.3 | 27 | 1.4 | <1 | <1 | — | Lung | A fumigatus (BAL) | Septate branched hyphae (lung, heart) | Regression |
| 3 | T-ALL | Chemo | NA | 0 | 33 | 22.8 | 466 | 59.7 | 7.8 | Lung, forearm | A flavus (biopsy) | Septate branched hyphae (forearm) | Regression |
| 4 | AML | Chemo | NA | 0 | 37 | 9.2 | >2000 | 80.8 | >24.8 | Lung | A fumigatus (biopsy) | Septate branched hyphae (disseminated)† | Regression |
| 5 | AML | Chemo | 0 | 0.2 | 31 | 6.7 | 6.8 | 29.8 | 0.23 | Lung | A fumigatus (biopsy) | Septate branched hyphae (disseminated)† | Regression |
| 6 | CML | MUD BMT | NA | 0.6 | 10 | 10.8 | ND | ND | ND | Lung, cerebral | A fumigatus(BAL) | NP | Stable |
| 7 | AML | Allo PBSCT | Ext cGVHD | 0.3 | NA | ND | ND | ND | ND | Lung | A fumigatus (BAL) | NP | Stable |
| 8 | AML | Allo PBSCT | Ext cGVHD | 0.7 | 7 | 12.8 | <1 | 10.8 | <0.09 | Lung | A fumigatus (BAL) | NP | Regression |
| Patients with possible invasive aspergillosis | |||||||||||||
| 9 | CML | MUD BMT | II | 0.2 | 20 | 2.3 | <1 | 174.4 | <0.006 | Lung | UD | NP | Progression |
| 10 | CML | MUD BMT | IV | 3.6 | 9 | 3.0 | 22.3 | 313 | 0.07 | Lung | UD | NP | Progression |
| 11 | CML | MUD BMT | II | 0.6 | 7 | 1.0 | <1 | 55.6 | <0.018 | Lung | UD | NP | Progression |
| 12 | AML | Chemo | NA | 0 | 15 | 14.3 | <1 | 607 | <0.0016 | Lung, cerebral | UD | NP | Stable |
| 13 | AML | Chemo | NA | 1.6 | 41 | 3.1 | <1 | <1 | — | Lung | UD | NP | Regression |
| 14 | ALL | Chemo | NA | 0.1 | 28 | 41.4 | 13.5 | 68.7 | 0.2 | Lung, cerebral | UD | NP | Regression |
| 15 | AML | Chemo | NA | 0 | 16 | 3.4 | <1 | <1 | — | Lung | UD | NP | Progression |
| 16 | AML | Chemo | NA | 0 | 26 | 20.8 | 3.8 | 39.5 | 0.1 | Lung | UD | NP | Stable |
| 17 | ALL | ChemoNA | 1.0 | 18 | 31.5 | 170.2 | >1000 | <0.17 | Lung | UD | NP | Progression | |
| 18 | AML | Chemo | NA | 1.2 | 27 | 1.3 | <1 | <1 | — | Lung | UD | NP | Stable |
| 19 | ALL | Chemo | NA | 0 | 22 | 8.9 | 175.4 | 792.7 | 0.22 | Lung | UD | NP | Progression |
| 20 | AML | Chemo | NA | 0 | 16 | ND | ND | ND | ND | Lung | UD | NP | Stable |
| Patient . | Disease . | Treatment modality . | GVHD grade . | Pred, mg/kg . | Neutropenia less than 500/μL, d . | SI . | IFN-γ, pg/mL . | IL-10, pg/mL . | Ratio IFN-γ/IL-10 . | Clinical sites of IA . | Aspergillus species . | Pathology . | Response* . |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patients with proven/probable invasive aspergillosis | |||||||||||||
| 1 | CLL | Allo PBSCT | II | 0 | 16 | 18.5 | 77.3 | 37.5 | 2.1 | Lung | UD | Septate branched hyphae (lung) | Stable |
| 2 | CML | Allo PBSCT | II | 1.3 | 27 | 1.4 | <1 | <1 | — | Lung | A fumigatus (BAL) | Septate branched hyphae (lung, heart) | Regression |
| 3 | T-ALL | Chemo | NA | 0 | 33 | 22.8 | 466 | 59.7 | 7.8 | Lung, forearm | A flavus (biopsy) | Septate branched hyphae (forearm) | Regression |
| 4 | AML | Chemo | NA | 0 | 37 | 9.2 | >2000 | 80.8 | >24.8 | Lung | A fumigatus (biopsy) | Septate branched hyphae (disseminated)† | Regression |
| 5 | AML | Chemo | 0 | 0.2 | 31 | 6.7 | 6.8 | 29.8 | 0.23 | Lung | A fumigatus (biopsy) | Septate branched hyphae (disseminated)† | Regression |
| 6 | CML | MUD BMT | NA | 0.6 | 10 | 10.8 | ND | ND | ND | Lung, cerebral | A fumigatus(BAL) | NP | Stable |
| 7 | AML | Allo PBSCT | Ext cGVHD | 0.3 | NA | ND | ND | ND | ND | Lung | A fumigatus (BAL) | NP | Stable |
| 8 | AML | Allo PBSCT | Ext cGVHD | 0.7 | 7 | 12.8 | <1 | 10.8 | <0.09 | Lung | A fumigatus (BAL) | NP | Regression |
| Patients with possible invasive aspergillosis | |||||||||||||
| 9 | CML | MUD BMT | II | 0.2 | 20 | 2.3 | <1 | 174.4 | <0.006 | Lung | UD | NP | Progression |
| 10 | CML | MUD BMT | IV | 3.6 | 9 | 3.0 | 22.3 | 313 | 0.07 | Lung | UD | NP | Progression |
| 11 | CML | MUD BMT | II | 0.6 | 7 | 1.0 | <1 | 55.6 | <0.018 | Lung | UD | NP | Progression |
| 12 | AML | Chemo | NA | 0 | 15 | 14.3 | <1 | 607 | <0.0016 | Lung, cerebral | UD | NP | Stable |
| 13 | AML | Chemo | NA | 1.6 | 41 | 3.1 | <1 | <1 | — | Lung | UD | NP | Regression |
| 14 | ALL | Chemo | NA | 0.1 | 28 | 41.4 | 13.5 | 68.7 | 0.2 | Lung, cerebral | UD | NP | Regression |
| 15 | AML | Chemo | NA | 0 | 16 | 3.4 | <1 | <1 | — | Lung | UD | NP | Progression |
| 16 | AML | Chemo | NA | 0 | 26 | 20.8 | 3.8 | 39.5 | 0.1 | Lung | UD | NP | Stable |
| 17 | ALL | ChemoNA | 1.0 | 18 | 31.5 | 170.2 | >1000 | <0.17 | Lung | UD | NP | Progression | |
| 18 | AML | Chemo | NA | 1.2 | 27 | 1.3 | <1 | <1 | — | Lung | UD | NP | Stable |
| 19 | ALL | Chemo | NA | 0 | 22 | 8.9 | 175.4 | 792.7 | 0.22 | Lung | UD | NP | Progression |
| 20 | AML | Chemo | NA | 0 | 16 | ND | ND | ND | ND | Lung | UD | NP | Stable |
Pred indicates prednisolone; IA, invasive aspergillosis; SI, stimulation index in response to EC SAB; CLL, chronic lymphocytic leukemia; allo PBSCT allogeneic peripheral blood stem cell transplantation from an HLA-identical sibling donor; —, not defined; CML, chronic myeloid leukemia; BAL, bronchoalveolar lavage; T-ALL, T-cell acute lymphocytic leukemia; Chemo, chemotherapy; AML, acute myeloid leukemia; MUD-BMT, bone marrow transplantation from an HLA-matched unrelated donor; ND, not determined; ext, extensive; cGVHD, chronic GVHD; NA, not applicable; UD, undetectable; and NP, not performed.
Status of invasive aspergillosis at the time of analysis.
After initial improvement of IA, patients 4 and 5 underwent an allogeneic SCT and finally died from IA.