Risk factors for invasive yeast infections in adult patients with hematological malignancies and/or stem cell transplant: systematic literature review and meta-analysis.
Emmanuelle Gras, Loris Azoyan, Patricia Monzo-Gallo et al.
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In 30 seconds
This systematic review and meta-analysis examined risk factors for invasive yeast infections (IYI) in adults with hematological malignancies or undergoing hematopoietic stem cell transplantation. Seven cohort or case-control studies included 27,925 patients and 590 IYI; five studies contributed to meta-analysis. Among allogeneic transplant recipients, male sex (HR 1.34 [95% CI 1.09-1.65]) and prior HSCT (HR 2.72 [95% CI 1.18-6.26]) were associated with IYI. Cord blood transplant was associated with candidemia, while central venous catheter presence was associated with IYI in patients with hematological malignancies.
Key findings
- In allogeneic HSCT recipients, male sex was associated with IYI (HR 1.34 [95% CI 1.09-1.65]).
- Prior HSCT was associated with IYI in the allogeneic HSCT population (HR 2.72 [95% CI 1.18-6.26]).
- Cord blood transplant was associated with increased candidemia risk (HR 3.03 [95% CI 1.99-4.60]).
- Among patients with hematological malignancies, central venous catheter presence was associated with IYI (OR 6.19 [95% CI 2.65-14.46]).
Why it matters
These pooled findings identify clinical and transplant-related characteristics associated with IYI in populations at substantial risk. Recognising these associations may help inform risk awareness and vigilance, while the evidence does not establish that the factors cause infection or that modifying them will prevent it.
What to keep in mind
The evidence came from seven observational cohort or case-control studies, and only five were eligible for meta-analysis; several pooled risk factors were based on two studies each.