High ferritin levels are associated with hepatosplenic candidiasis in hematopoietic stem cell transplant candidates.

Abstract

OBJECTIVES:

Invasive fungal infections (IFI) are a significant cause of morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients. Hepatosplenic candidiasis (HSC) is defined as a distinct form of invasive candidiasis, with liver, spleen, and kidney involvement, in patients with hematological disorders.

METHODS:

The charts of 255 patients (male/female 168/87; median age 35 (range 16-71) years) who were evaluated pre-HSCT at the Gazi University Hospital Stem Cell Transplantation Unit between 2003 and 2008, were retrospectively reviewed.

RESULTS:

HSC, which was demonstrated in six (2.3%) patients, was found to be more common in allogeneic HSCT recipients than in autologous HSCT recipients and in patients who had received two or more previous chemotherapy courses than in patients who had received fewer than two (p>0.05). Patients with HSC tended to have a worse performance status than patients without HSC according to the World Health Organization (p=0.001) and Karnofsky scale (p=0.007). Pre-transplantation ferritin (p=0.008) and acute phase reactant levels, including erythrocyte sedimentation rate (p=0.025) and C-reactive protein (p=0.007), were significantly higher in patients with HSC than in patients without HSC.

CONCLUSIONS:

This study shows the predictive role of pre-transplantation ferritin levels in selecting a subset of patients at increased risk for HSC. Pre-transplantation risk assessment and targeted strategies might lower the morbidity and mortality of IFI in HSCT recipients.

• Authors: Ozlem Güzel Tunçcan, Zeynep Arzu Yegin, Zübeyde Nur Ozkurt, Gonca Erbaş, Sahika Zeynep Akı, Esin Senol, Münci Yağcı, Gülsan Sucak
• Journal: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (Int J Infect Dis) Vol. 14 Suppl 3 Pg. e104-7 (Sep 2010) ISSN: 1878-3511 [Electronic] Canada
• PMID: 20307998 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Ferritins

Topics

• Adolescent
• Adult
• Aged
• Candidiasis, Invasive (blood, etiology, mortality)
• Fatal Outcome
• Female
• Ferritins (blood)
• Hematologic Neoplasms (blood, therapy)
• Hematopoietic Stem Cell Transplantation (adverse effects, mortality)
• Humans
• Liver Diseases (blood, etiology, mortality)
• Male
• Middle Aged
• Retrospective Studies
• Risk Factors
• Splenic Diseases (blood, etiology, mortality)
• Transplantation, Autologous
• Transplantation, Homologous
• Turkey (epidemiology)
• Young Adult