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<publisher>HAL CCSD</publisher>
<title lang=en>Indications and outcomes of antifungal therapy in French patients with haematological conditions or recipients of haematopoietic stem cell transplantation.</title>
<creator>Herbrecht, Raoul</creator>
<creator>Caillot, Denis</creator>
<creator>Cordonnier, Catherine</creator>
<creator>Auvrignon, Anne</creator>
<creator>Thiébaut, Anne</creator>
<creator>Brethon, Benoît</creator>
<creator>Michallet, Mauricette</creator>
<creator>Mahlaoui, Nizar</creator>
<creator>Bertrand, Yves</creator>
<creator>Preziosi, Paul</creator>
<creator>Ruiz, Fabrice</creator>
<creator>Gorin, Norbert-Claude</creator>
<creator>Gangneux, Jean-Pierre</creator>
<contributor>Service d'Hématologie ; CHU Strasbourg</contributor>
<contributor>Hôpital du Bocage ; Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)</contributor>
<contributor>Service d'hématologie clinique ; Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)</contributor>
<contributor>CHU Trousseau [APHP]</contributor>
<contributor>Service d'hématologie [Lyon] ; Hospices Civils de Lyon - Hôpital Edouard Herriot</contributor>
<contributor>IFR Necker-Enfants Malades (IRNEM) ; Assistance publique - Hôpitaux de Paris (AP-HP) - Université Paris Descartes - Paris 5 (UPD5) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Centre National de la Recherche Scientifique (CNRS)</contributor>
<contributor>Hématologie et immunologie pédiatrique ; Hospices Civils de Lyon - CHU Lyon - Institut d'Hématologie et d'Oncologie Pédiatrique (IHOP) - Hôpital Femme-Mère-Enfant (HFME)</contributor>
<contributor>Service d'hématologie clinique et de thérapie cellulaire [CHU Saint-Antoine] ; Assistance publique - Hôpitaux de Paris (AP-HP) - CHU Saint-Antoine [APHP]</contributor>
<contributor>Institut de recherche, santé, environnement et travail [Rennes] (Irset) ; Université d'Angers (UA) - Université des Antilles et de la Guyane (UAG) - Université de Rennes 1 (UR1) - École des Hautes Études en Santé Publique [EHESP] (EHESP) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )</contributor>
<description>International audience</description>
<source>ISSN: 0305-7453</source>
<source>EISSN: 1460-2091</source>
<source>Journal of Antimicrobial Chemotherapy</source>
<publisher>Oxford University Press (OUP)</publisher>
<identifier>hal-00874741</identifier>
<identifier>https://hal.archives-ouvertes.fr/hal-00874741</identifier>
<source>https://hal.archives-ouvertes.fr/hal-00874741</source>
<source>Journal of Antimicrobial Chemotherapy, Oxford University Press (OUP), 2012, 67 (11), pp.2731-8. 〈10.1093/jac/dks266〉</source>
<identifier>DOI : 10.1093/jac/dks266</identifier>
<relation>info:eu-repo/semantics/altIdentifier/doi/10.1093/jac/dks266</relation>
<identifier>PUBMED : 22850692</identifier>
<relation>info:eu-repo/semantics/altIdentifier/pmid/22850692</relation>
<language>en</language>
<subject lang=en>invasive fungal disease</subject>
<subject lang=en>haematology</subject>
<subject lang=en>haematopoietic stem cell transplantation</subject>
<subject lang=en>mortality</subject>
<subject lang=en>invasive aspergillosis</subject>
<subject lang=en>invasive candidiasis</subject>
<subject>[SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology</subject>
<type>info:eu-repo/semantics/article</type>
<type>Journal articles</type>
<description lang=en>OBJECTIVES: Invasive fungal disease (IFD) remains a major concern in patients with haematological conditions. We describe diagnoses, therapeutic management and outcomes in unselected consecutive patients from haematological facilities treated for suspected or documented IFD. METHODS: In this observational prospective study, children/adults with haematological conditions or haematopoietic stem cell transplantation (HSCT) were recruited upon start of non-prophylactic systemic antifungal treatment in 37 French haematological facilities (December 2007 to December 2008). IFD episodes were classified according to the 2008 EORTC/MSG criteria. RESULTS: The cohort included 419 patients (298 adults and 121 children): 88% haematological malignancies, 28% HSCT recipients and 68% neutropenic. Patients had 423 IFD episodes: 21% mycologically documented (59% probable/proven aspergillosis, 32% proven candidiasis and 9% probable/proven other IFD) and 20% classified as possible IFD. The remaining cases were assigned to two groups: febrile neutropenia (34%) and unclassified (25%), 9% of which were classified as possible/probable/proven IFD by day 7. Treatment was thus initiated early in 59% of patients; liposomal amphotericin B and caspofungin were the most common single-agent therapies. The 12 week mortality was 18% for probable/proven aspergillosis, 15% for proven candidiasis, 10% for probable/proven other IFD, 9% for possible IFD, 3% for febrile neutropenia and 12% for unclassified episodes (log rank P = 0.016); it was dependent on age, complete remission of underlying haematological disease and mechanical ventilation. CONCLUSIONS: In this comprehensive sample of haematological patients receiving antifungal treatment, we observe a widespread resort to early therapy and a low mortality rate, including in patients with probable or proven IFD.</description>
<date>2012-11</date>
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