Numbers of Probable IA Cases According to Antifungal Prophylaxis Cohort With Percent Reclassified by the 2020 Definitions
Numbers of Patients With Invasive Fungal Infection Through Day 180 and Day 365 . | . | . | . | . | . | . | . | . | . | . | . | . |
---|---|---|---|---|---|---|---|---|---|---|---|---|
. | 0101 Study Definition . | . | . | . | 2020 Classification (% Probable IA Reclassified) . | . | . | . | . | . | . | . |
. | (Modified 2002 Classification) . | . | . | . | . | . | . | . | . | . | . | . |
IFI Category . | Days 0–180 . | . | Days 0–365 . | . | Days 0–180 . | . | . | . | Days 0–365 . | . | . | . |
. | FLU . | VORI . | FLU . | VORI . | FLU . | . | VORI . | . | FLU . | . | VORI . | . |
. | . | . | . | . | Unchanged . | Reclassifieda . | Unchanged . | Reclassifieda . | Unchanged . | Reclassifieda . | Unchanged . | Reclassifieda . |
Proven | ||||||||||||
Aspergillus | 3 | 0 | 5 | 2 | 3 | 0 | 5 | 2 | ||||
Non-Aspergillus IFDb,c | 6 | 5 | 8 | 13 | 6 | 5 | 8 | 13 | ||||
Subtotal | 9 | 5 | 13 | 15 | 9 | 5 | 13 | 15 | ||||
Probable | ||||||||||||
Aspergillus | 14 | 9 | 16 | 15d | 10 | 4e (28) | 2f | 3f (60) | 11 | 5e (31) | 7f | 4f (36) |
Non-Aspergillus IFDg | 1 | 0 | 2 | 0 | 1 | 0 | 0 | 0 | 2 | 0 | 0 | 0 |
Presumptive | 9 | 8 | 10 | 8 | h | h | h | h | h | h | h | h |
Subtotal (probable/presumptive) | 24 | 17 | 28 | 23 | 11 | 4 | 2f | 3f | 13 | 5 | 7f | 4f |
Total IFIs | ||||||||||||
Proven/probable/presumptive | 33 | 22 | 41 | 38 | 20 | 4 | 7f | 3f | 26 | 5 | 22f | 4f |
Numbers of Patients With Invasive Fungal Infection Through Day 180 and Day 365 . | . | . | . | . | . | . | . | . | . | . | . | . |
---|---|---|---|---|---|---|---|---|---|---|---|---|
. | 0101 Study Definition . | . | . | . | 2020 Classification (% Probable IA Reclassified) . | . | . | . | . | . | . | . |
. | (Modified 2002 Classification) . | . | . | . | . | . | . | . | . | . | . | . |
IFI Category . | Days 0–180 . | . | Days 0–365 . | . | Days 0–180 . | . | . | . | Days 0–365 . | . | . | . |
. | FLU . | VORI . | FLU . | VORI . | FLU . | . | VORI . | . | FLU . | . | VORI . | . |
. | . | . | . | . | Unchanged . | Reclassifieda . | Unchanged . | Reclassifieda . | Unchanged . | Reclassifieda . | Unchanged . | Reclassifieda . |
Proven | ||||||||||||
Aspergillus | 3 | 0 | 5 | 2 | 3 | 0 | 5 | 2 | ||||
Non-Aspergillus IFDb,c | 6 | 5 | 8 | 13 | 6 | 5 | 8 | 13 | ||||
Subtotal | 9 | 5 | 13 | 15 | 9 | 5 | 13 | 15 | ||||
Probable | ||||||||||||
Aspergillus | 14 | 9 | 16 | 15d | 10 | 4e (28) | 2f | 3f (60) | 11 | 5e (31) | 7f | 4f (36) |
Non-Aspergillus IFDg | 1 | 0 | 2 | 0 | 1 | 0 | 0 | 0 | 2 | 0 | 0 | 0 |
Presumptive | 9 | 8 | 10 | 8 | h | h | h | h | h | h | h | h |
Subtotal (probable/presumptive) | 24 | 17 | 28 | 23 | 11 | 4 | 2f | 3f | 13 | 5 | 7f | 4f |
Total IFIs | ||||||||||||
Proven/probable/presumptive | 33 | 22 | 41 | 38 | 20 | 4 | 7f | 3f | 26 | 5 | 22f | 4f |
Abbreviations: BMT CTN, Blood and Marrow Transplant Clinical Trials Network; FLU, fluconazole; GM, galactomannan; IA, invasive aspergillosis; IFD, invasive fungal disease; IFI, invasive fungal infection; VORI, voriconazole.
aMost of the reclassified cases were due to serum samples; there were only 4 BAL samples. For those on antecedent antifungal drugs for at least 72 hours, fluconazole was the most common; few were on voriconazole, other antimould antifungals, or echinocandins.
bChaetomium, Pseudallescheria boydii, Alternaria, and hyphae invading tissue with negative culture.
cZygomycetes followed by Candida krusei, Zygomycetes followed by Candida glabrata, and Candida albicans followed by Zygomycetes.
dIncludes 1 mixed infection due to Aspergillus and Zygomycetes.
eIncludes 3 cases reclassified as possible IFD and 1 case as probable IFD.
fExcludes 4 cases that did not have quantitative GM values to determine if they met new criteria.
gPaecilomyces/Nocardia and Paecilomyces/Nocardia and Pneumocystis jiroveci.
hPresumptive cases in the BMT CTN 0101 modified definition were reclassified to possible IFD in the 2008 and 2020 classification.
Numbers of Probable IA Cases According to Antifungal Prophylaxis Cohort With Percent Reclassified by the 2020 Definitions
Numbers of Patients With Invasive Fungal Infection Through Day 180 and Day 365 . | . | . | . | . | . | . | . | . | . | . | . | . |
---|---|---|---|---|---|---|---|---|---|---|---|---|
. | 0101 Study Definition . | . | . | . | 2020 Classification (% Probable IA Reclassified) . | . | . | . | . | . | . | . |
. | (Modified 2002 Classification) . | . | . | . | . | . | . | . | . | . | . | . |
IFI Category . | Days 0–180 . | . | Days 0–365 . | . | Days 0–180 . | . | . | . | Days 0–365 . | . | . | . |
. | FLU . | VORI . | FLU . | VORI . | FLU . | . | VORI . | . | FLU . | . | VORI . | . |
. | . | . | . | . | Unchanged . | Reclassifieda . | Unchanged . | Reclassifieda . | Unchanged . | Reclassifieda . | Unchanged . | Reclassifieda . |
Proven | ||||||||||||
Aspergillus | 3 | 0 | 5 | 2 | 3 | 0 | 5 | 2 | ||||
Non-Aspergillus IFDb,c | 6 | 5 | 8 | 13 | 6 | 5 | 8 | 13 | ||||
Subtotal | 9 | 5 | 13 | 15 | 9 | 5 | 13 | 15 | ||||
Probable | ||||||||||||
Aspergillus | 14 | 9 | 16 | 15d | 10 | 4e (28) | 2f | 3f (60) | 11 | 5e (31) | 7f | 4f (36) |
Non-Aspergillus IFDg | 1 | 0 | 2 | 0 | 1 | 0 | 0 | 0 | 2 | 0 | 0 | 0 |
Presumptive | 9 | 8 | 10 | 8 | h | h | h | h | h | h | h | h |
Subtotal (probable/presumptive) | 24 | 17 | 28 | 23 | 11 | 4 | 2f | 3f | 13 | 5 | 7f | 4f |
Total IFIs | ||||||||||||
Proven/probable/presumptive | 33 | 22 | 41 | 38 | 20 | 4 | 7f | 3f | 26 | 5 | 22f | 4f |
Numbers of Patients With Invasive Fungal Infection Through Day 180 and Day 365 . | . | . | . | . | . | . | . | . | . | . | . | . |
---|---|---|---|---|---|---|---|---|---|---|---|---|
. | 0101 Study Definition . | . | . | . | 2020 Classification (% Probable IA Reclassified) . | . | . | . | . | . | . | . |
. | (Modified 2002 Classification) . | . | . | . | . | . | . | . | . | . | . | . |
IFI Category . | Days 0–180 . | . | Days 0–365 . | . | Days 0–180 . | . | . | . | Days 0–365 . | . | . | . |
. | FLU . | VORI . | FLU . | VORI . | FLU . | . | VORI . | . | FLU . | . | VORI . | . |
. | . | . | . | . | Unchanged . | Reclassifieda . | Unchanged . | Reclassifieda . | Unchanged . | Reclassifieda . | Unchanged . | Reclassifieda . |
Proven | ||||||||||||
Aspergillus | 3 | 0 | 5 | 2 | 3 | 0 | 5 | 2 | ||||
Non-Aspergillus IFDb,c | 6 | 5 | 8 | 13 | 6 | 5 | 8 | 13 | ||||
Subtotal | 9 | 5 | 13 | 15 | 9 | 5 | 13 | 15 | ||||
Probable | ||||||||||||
Aspergillus | 14 | 9 | 16 | 15d | 10 | 4e (28) | 2f | 3f (60) | 11 | 5e (31) | 7f | 4f (36) |
Non-Aspergillus IFDg | 1 | 0 | 2 | 0 | 1 | 0 | 0 | 0 | 2 | 0 | 0 | 0 |
Presumptive | 9 | 8 | 10 | 8 | h | h | h | h | h | h | h | h |
Subtotal (probable/presumptive) | 24 | 17 | 28 | 23 | 11 | 4 | 2f | 3f | 13 | 5 | 7f | 4f |
Total IFIs | ||||||||||||
Proven/probable/presumptive | 33 | 22 | 41 | 38 | 20 | 4 | 7f | 3f | 26 | 5 | 22f | 4f |
Abbreviations: BMT CTN, Blood and Marrow Transplant Clinical Trials Network; FLU, fluconazole; GM, galactomannan; IA, invasive aspergillosis; IFD, invasive fungal disease; IFI, invasive fungal infection; VORI, voriconazole.
aMost of the reclassified cases were due to serum samples; there were only 4 BAL samples. For those on antecedent antifungal drugs for at least 72 hours, fluconazole was the most common; few were on voriconazole, other antimould antifungals, or echinocandins.
bChaetomium, Pseudallescheria boydii, Alternaria, and hyphae invading tissue with negative culture.
cZygomycetes followed by Candida krusei, Zygomycetes followed by Candida glabrata, and Candida albicans followed by Zygomycetes.
dIncludes 1 mixed infection due to Aspergillus and Zygomycetes.
eIncludes 3 cases reclassified as possible IFD and 1 case as probable IFD.
fExcludes 4 cases that did not have quantitative GM values to determine if they met new criteria.
gPaecilomyces/Nocardia and Paecilomyces/Nocardia and Pneumocystis jiroveci.
hPresumptive cases in the BMT CTN 0101 modified definition were reclassified to possible IFD in the 2008 and 2020 classification.
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