Mucormycosis in allogeneic bone marrow transplant recipients:: report of five cases and review of the role of iron overload in the pathogenesis

被引:141
作者
Maertens, J
Demuynck, H
Verbeken, EK
Zachée, P
Verhoef, GEG
Vandenberghe, P
Boogaerts, MA
机构
[1] Univ Hosp Leuven, Dept Hematol, Louvain, Belgium
[2] Univ Hosp Leuven, Dept Pathol, Louvain, Belgium
关键词
bone marrow transplantation; mucormycosis; iron overload;
D O I
10.1038/sj.bmt.1701885
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
In a 10-year consecutive series of 263 allogeneic bone marrow transplant recipients, we identified five eases (1.9%) of invasive mucormycosis, Only one infection occurred within the first 100 days after transplantation, while the remainder complicated the late post-transplant course (median day of diagnosis: 343), Sites of infection were considered 'non-classical' and included pulmonary, cutaneous and gastric involvement, No case of fungal dissemination was observed, Mucormycosis was the primary cause of death in three of the five patients. Corticosteroid-treated graft-versus-host disease, either acute or chronic, or severe neutropenia were present in all cases, However, compared with a matched control population, the most striking finding was the demonstration of severe iron overload in each of the mucormycosis patients, The mean level of serum ferritin, transferrin saturation and number of transfused units of red cells (2029 mu g/l, 92% and 52 units, respectively) in the study group is significantly higher compared with the control group (P < 0.05). The difference with other risk groups for mucormycosis, including deferoxamine-treated dialysis patients and acidotic diabetics, was analyzed in view of the possible pathogenic role of iron. Although these infections are often fatal, limited disease may have a better prognosis if diagnosed early and treated aggressively.
引用
收藏
页码:307 / 312
页数:6
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