Table 1.
Characteristics of 98 Patients With Multiple Myeloma and Neutropenia-Related Invasive Aspergillosis Defined at Baseline and After the Diagnosis of Aspergillosis
| Characteristic | Value |
|---|---|
| At baselinea | |
| Sex, male:female | 53:45 |
| Age, years | 61 (38–81) |
| Body surface area, m2 | 1.81 (1.30–2.55) |
| Bone mass index | 25.60 (16.20–43.37) |
| Active myeloma | 81 (83) |
| Antineoplastic treatment | |
| ASCT | 50 (51) |
| Chemotherapy | 48 (49) |
| Prior ASCT | 1 (0–4) |
| Months from diagnosis of underlying disease to IA | 24 (0–186) |
| Days from chemotherapy to diagnosis of IA | 11 (0–32) |
| Receipt of corticosteroids | 94 (96) |
| Cumulative prednisone equivalent dose in mg | 1150 (0–7590) |
| Other immunosuppressive therapiesb | 17 (17) |
| WBC count, cells/mm3 | 3365 (10–26,610) |
| ANC, neutrophils/mm3 | 2178 (0–22,314) |
| ALC, lymphocytes/mm3 | 375 (0–4554) |
| Platelet count, ×103 platelets/mm3 | 73 (7–345) |
| Serum level of uninvolved Ig, mg/dL | 222 (10–985) |
| Absolute CD4 cell, count/mm3 | 189 (19–1192) |
| Creatinine clearance rate, mL/min | 60 (2–171) |
| Serum bilirubin level, mg/dL | 0.6 (0.2–1.6) |
| Cytomegalovirus seropositive | 65 (66) |
| At diagnosis of aspergillosis | |
| ANC, neutrophils/mm3 | 14 (0–10,900) |
| Days with ANC <500 neutrophils/mm3 | 10 (1–54) |
| Days with ANC <100 neutrophils/mm3 | 7 (1–27) |
| s-GMI tests, No. | 21 (4–64) |
| Cytomegalovirus reactivationc | 14/65 (21) |
| Concomitant respiratory viral infectiond | 12 (12) |
| Classification of aspergillosis | |
| Proven | 5 (5) |
| Probable | 61 (652) |
| Probable without prespecified radiologic findingse | 32 (33) |
| Antifungal treatment | |
| None | 6 (6) |
| Voriconazole | 55 (56) |
| Liposomal amphotericin B | 25 (26) |
| Otherf | 12 (12) |
Data are No. or proportion (%) of patients or median (range).
Abbreviations: ALC, absolute lymphocyte count; ANC, absolute neutrophil count; ASCT, autologous stem cell transplantation; IA, invasive aspergillosis; Ig, immunoglobulin; RSV, respiratory syncytial virus; s-GMI, serum Aspergillus galactomannan index; WBC, white blood cell.
a Baseline refers to variables measured immediately prior to starting the antineoplastic regimen after which IA was diagnosed.
b Other immunosuppressive therapies included sirolimus (in 12 patients) and alemtuzumab, rituximab, fludarabine, etanercept, and sirolimus + rituximab (in 1 each).
c Defined as >600 copies per mL of plasma by quantitative polymerase chain reaction.
d Concomitant viral infections included RSV (in 5 patients), influenza B virus (in 2), and RSV + influenza B virus, parainfluenza virus type 3, influenza A virus, metapneumovirus, and RSV + parainfluenza type 3 (in 1 each).
e As defined in [26].
f Other treatments included voriconazole + liposomal amphotericin B (in 4 patients), voriconazole + micafungin (in 2), micafungin (in 3), anidulafungin (in 2), and voriconazole + anidulafungin or voriconazole + placebo (in 1).