Risk Stratification of Patients
Distribution of IFIs in patients with haematological malignancies1
Risk stratification helps identify the patients likely to suffer from invasive aspergillosis, even if they do not present the classical risk factors, as defined in the guidelines or clinical trials2
During one of the largest epidemiology studies evaluating the incidence of IFIs in Europe, 92% (2,773/3,012) of patients with AML did not develop a mould infection1
Aspergillus species was the most common cause of mould infection1
Knowing which patients are at risk of developing invasive aspergillosis may aid early diagnosis and initiation of appropriate anti-fungal therapy1
Stratification of risk factors for IA requires distinction between different risk factors affecting the primary host condition2
- Consideration needs to be given to:2
- multiplicity of risk factors
- synergy between different risk factors
- Correct identification of the main risk factors for developing an IFD is essential in the evaluation of immunocompromised patients – and allows timely institution of appropriate antifungal therapy3
ALL, acute lymphoblastic leukaemia; AML, acute myeloid leukaemia; CLL, chronic lymphoblastic leukaemia; CML, chronic myeloid leukaemia; NHL, Non-Hodgkin lymphoma; HD, Hodgkin Disease; MM, multiple myeloma; IA, invasive aspergillosis; IFD, invasive fungal disease; IFI, invasive fungal infection; GvHD, graft versus host disease; HEPA, high-efficiency particulate air; HSCT, haematopoietic stem cell transplant; IA, invasive aspergillosis; ROS, reactive oxygen species;
- Pagano L, et al. Haematological. 2006; 91: 1068–75.
- Herbrecht R, et al. Ann N Y Acad Sci. 2012; 1272: 23–30.
- Pagano L, et al. J Antimicrob Chemother. 2011; 66(Suppl 1): i5–14.