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Infections Post Transplant

A nationwide survey of deep fungal infections and fungal prophylaxis after hematopoietic stem cell transplantation in Japan

Bone Marrow Transplantation volume 33, pages 1173–1179 (2004)Cite this article

Summary:

We conducted a nationwide survey to define incidence of deep fungal infections and fungal prophylaxis practices after HSCT. In all, 63 institutions responded. Total number of in-patient transplantations was 935: 367 autologous, 414 allogeneic myeloablative, and 154 allogeneic reduced-intensity (RIST) (n=154). Number of patients who were cared for in a clean room at transplant was 261 (71%) in autologous, 409 (99%) in conventional and 93 (66%) in RIST, respectively. All patients received prophylactic antifungal agents; 89% fluconazole. Number of patients who received the dosage recommended in the CDC guidelines (400 mg/day) was 135 (42%) in conventional transplant and 34 (30%) in RIST (P=0.037). Number of patients who received fluconazole until engraftment and beyond day 75 in conventional transplant vs RIST was, respectively, 324 (100%) vs 109 (97%), and 39 (12%) vs 18 (16%), with no significant difference between the two groups. A total of 37 patients (4.0%) were diagnosed with deep fungal infections; autologous transplantation (0.03%), conventional transplantation (6.0%) and RIST (7.1%). Wide variations in antifungal prophylaxis practice according to the type of transplant and the institutions, and deep fungal infection remain significant problems in RIST.

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Acknowledgements

This study was supported by a Grant-in-Aid for scientific research from the Ministry of Health, Labor and Welfare.

Author information

Authors and Affiliations

  1. Hematopoietic Stem Cell Transplant Unit, National Cancer Center Hospital, Tokyo, Japan

    O Imataki, M Kami, S-W Kim & Y Takaue

  2. The Division of Hematology, Teikyo University School of Medicine, Tokyo, Japan

    M Gotoh & S Komaba

  3. Department of Internal Medicine, Sapporo Hokuyu Hospital, Hokkaido, Japan

    M Kasai

  4. Department of Hematology and Gastroenterology, Hokkaido University School of Medicine, Hokkaido, Japan

    S Hashino

  5. Department of Medicine III, Hamamatsu University School of Medicine, Shizuoka, Japan

    K Naito

  6. The Division of Hematology, Tokyo Women's Medical School, Tokyo, Japan

    M Masuda

  7. Institute of Development, Aging and Cancer, Tohoku University, Miyagi, Japan

    K Anan

  8. Internal Medicine, Osaka City General Hospital, Osaka, Japan

    H Teshima

  9. Department of Internal Medicine, Kochi Medical School, Kochi, Japan

    K Togitani

  10. Department of Hematology, Shiga University of Medical Science, Shiga, Japan

    T Inoue

  11. Second Department of Internal Medicine, Chiba University Medical School, Chiba, Japan

    M Nishimura

  12. Internal Medicine, Shakaihoken Kobe Central Hospital, Hyogo, Japan

    Y Adachi

  13. Department of Internal Medicine, Asahikawa City Hospital, Hokkaido, Japan

    T Fukuhara

  14. Third Department of Internal Medicine, National Defense Medical College, Saitama, Japan

    T Yamashita

  15. Department of Hematology, National Kyushu Cancer Center, Fukuoka, Japan

    N Uike

  16. Division of Hematology and Oncology, Department of Internal Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Y Kobayashi

  17. Department of Hematology, Nagoya National Hospital Clinical and Research Center, Aichi, Japan

    M Hamaguchi

  18. Department of Hematology, Hamanomachi General Hospital, Fukuoka, Japan

    M Higuchi

  19. Division of Hematology, Suzuka General Hospital, Mie, Japan

    K Kawakami

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  1. O Imataki
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Corresponding author

Correspondence to M Kami.

Appendix

Appendix

This study was conducted at the following institutions under the auspices of the following investigators in Japan:

Masaya Mukai (Sapporo City General Hospital, Hokkaido), Aoyagi Yumei (Dokkyo University School of Medicine, Tochigi), Kazuaki Yakushiji (Kurume University School of Medicine, Fukuoka), Hisashi Tsurumi (Gifu University School of Medicine, Gifu), Yukiyoshi Moriuchi (Sasebo City General Hospital, Nagasaki), Shin Imamura (Fukui Medical University, Fukui), Hiroatu Ago (Shimane Prefectural Central Hospital, Shimane), Sachiko Suzuki (Hakodate Central General Hospital, Hokkaido), Akira Yokota (Chiba Aoba Municipal Hospital, Chiba), Hideki Mitsui (Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka), Yuichi Ishikawa (Chukyo Hospital, Aichi), Yasushi Takamatsu (Fukuoka University School of Medicine, Fukuoka), Kazutaka Sunami (National Okayama Medical Center, Okayama), Nobuo Masauzi (Hakodate Manucipal Hospital, Hokkaido), Tsunehiko Komatsu (Tsukuba Memorial Hospital, Ibaraki), Tadao Ishida (Sapporo Medical University School of Medicine, Hokkaido), Hideo Hyodo (Hiroshima University Research Institute for Radiation Biology and Medicine, Hiroshima), Hiroto Kaneko (Aiseikai-Yamashina Hospital, Kyoto), Hidetaka Takimoto (Kochi Municipal Central Hospital, Kochi), Tadasu Tobita (Yakizu City Hospital, Shiga), Tsutomu Kato (Toyama Medical and Pharmaceutical University, Toyama), Eiichi Ohtsuka (Oita Medical University, Oita), Hideo Kimura (Kita-Fukushima Medical Center, Fukushima), Kimiharu Uozumi (Kagoshima University, Faculty of Medicine, Kagoshima), Toshiro Ito (Shinshu University, The Department of Medicine, Nagano), Masami Inoue (Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka), Yoshinao Yamamoto (Kishiwada City Hospital, Osaka), Shoichi Doi (Kyoto-Katsura Hospital, Kyoto), Yasuhiko Miyazaki (Kansai Medical University, Osaka), Jyunichi Yamagami (Saitama Prefectural Children Medical Center, Saitama), Toshiharu Tamaki (Rinku General Medical Center, Osaka), Yujiro Yamano (Kyushu Kosei-Nenkin Hospital, Fukuoka), Makoto Hirokawa (Akita University School of Medicine, Akita), Shuji Ozaki (Tokushima University Hospital, Tokushima), Koichiro Muta (Kyushu University Graduate School of Medical Science, Fukuoka), Shuichi Hanada (National Kyushu Cardiovascular Center, Fukuoka), Nobuhiko Uoshima (Matsushita Memorial Hospital, Osaka), Hiroyuki Tsuda (Kumamoto City Hospital, Kumamoto), Chihiro Shimazaki (Kyoto Prefectural University of Medicine, Kyoto), Atsushi Wakita (Nagoya City University Graduate School of Medical Sciences, Aichi), Tetsuya E Tanimoto (Kyushu University Faculty of Medicine, Fukuoka), Masaki Ri (Shizuoka Saiseikai General Hospital, Shizuoka), Eisaburo Sueoka (Saga Medical School, Saga), Jyunichi Tsukada (University of Occupational and Environmental Health School of Medicine, Fukuoka), Akihiro Ihara (National Hospital Kure Medical Center, Hiroshima).

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Imataki, O., Kami, M., Kim, SW. et al. A nationwide survey of deep fungal infections and fungal prophylaxis after hematopoietic stem cell transplantation in Japan. Bone Marrow Transplant 33, 1173–1179 (2004). https://doi.org/10.1038/sj.bmt.1704526

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