Table 1.
Characteristics of Patients and Invasive Mold Infections
| n = 41 | |
|---|---|
| Demographic characteristics | |
| Male/female | 27 (66)/14 (34) |
| Age, y | 61 (8–83) |
| Main underlying diseases | |
| Acute leukemiaa | 16 (39) |
| Other hematologic cancerb | 5 (12) |
| Allogeneic HSCT | 4 (10) |
| Solid organ transplantationc | 3 (7) |
| Auto-immune disordersd | 6 (15) |
| Solid tumorse | 5 (12) |
| Otherf | 2 (5) |
| Immunosuppressive conditionsg | |
| Neutropeniah | 19 (46) |
| Corticosteroid treatmenti | 11 (27) |
| Calcineurin inhibitors | 6 (15) |
| Other immunosuppressive drugsj | 7 (17) |
| Recent anticancer chemotherapy | 22 (54) |
| Documented site of infection | |
| Lung only/disseminated (lung + other)k | 32 (78)/9 (22) |
| Type of IMI | |
| Invasive aspergillosisl | 21 (51) |
| Invasive mucormycosism | 10 (24) |
| Mixed invasive aspergillosis/mucormycosisn | 2 (5) |
| Other invasive mold infectiono | 2 (5) |
| Unspecified mold infectionp | 6 (15) |
| EORTC/MSGERC criteria (before histopathology)q | |
| Host criteria 2008/2020 | 32 (78)/34 (83) |
| Clinical and radiological criteria 2008/2020 | 33 (80)/33 (80) |
| Mycological criteria 2008/2020 | 17 (41)/16 (39) |
| IMI 2008: probable/possible/no criteria | 14 (34)/15 (37)/12 (29) |
| IMI 2020: probable/possible/no criteria | 14 (34)/17 (41)/10 (24) |
| Clinical appreciation (before histopathology) | |
| Clinical suspicion of IMI | 30 (73) |
| Mold-active antifungal therapy initiatedr | 21 (51) |
Numbers are total No. (%) or median (range).
Abbreviations: EORTC/MSGERC, European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium; HSCT, hematopoietic stem cell transplantation; IMI, invasive mold infection.
aAcute myeloid leukemia (12), acute lymphoid leukemia (4).
bLymphoma (2), chronic myeloid leukemia (1), multiple myeloma (1), myelodysplastic syndrome (1).
cLung transplantation (2), heart transplantation (1).
dHemophagocytic syndrome (2), disseminated lupus (1), rheumatoid arthritis (1), myasthenia gravis (1), idiopathic pulmonary fibrosis (1).
ePrimary tumor site: cerebral (2), lung (1), thyroid (1), multimetastatic cancer of unknown origin (1).
fMultiple pulmonary infarcts (1), drug-induced neutropenia (1).
gMore than 1 possible.
hNeutrophils <500/mm3 for >10 days in the past 60 days.
i≥0.3 mg/kg prednisone-equivalent for ≥3 weeks in the past 60 days.
jMycophenolate mofetil (3), tyrosine kinase inhibitors (2), anti–tumor necrosis factor (TNF) alpha (1), pomalidomide (1).
kMore than 1 possible: brain (3), heart (3), thyroid (3), spleen (2), liver (2), intestine (1), kidney (1), skin (1).
lA. fumigatus (18), A. flavus (2), mixed A. fumigatus and A. flavus (1).
mRhizomucor spp. (5), Rhizopus spp. (1), Lichtheimia spp. (1), mixed Rhizomucor spp. and Rhizopus spp. (1), unspecified “Mucorales” (large nonseptate hyphae at histopathology without microbiological documentation) (2).
nA. fumigatus and Lichtheimia spp., presumed Aspergillus spp. (positive GM only), and Rhizomucor spp.
oConidiobolus spp., Hormographiella aspergillata.
pSeptate branched hyphae at histopathology without microbiological documentation.
rAmphotericin B formulations or mold-active triazoles (voriconazole, posaconazole, isavuconazole).