Genetic Risk Surveillance for Invasive Aspergillosis in Hematology Patients: A Prospective Observational Study
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ORIGINAL RESEARCH
Genetic Risk Surveillance for Invasive Aspergillosis in Hematology Patients: A Prospective Observational Study Tananun Tanpaibule . Natini Jinawath . Aruchalean Taweewongsounton . Pimjai Niparuck . Porpon Rotjanapan
Received: July 10, 2020 The Author(s) 2020
ABSTRACT Introduction: The association between genetic background and the risk of invasive aspergillosis (IA) has not been addressed in Thailand. We
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12794684. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40121020-00331-4) contains supplementary material, which is available to authorized users. T. Tanpaibule P. Rotjanapan (&) Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand e-mail: [email protected] N. Jinawath Program in Translational Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand N. Jinawath Integrative Computational BioScience Center (ICBS), Mahidol University, Nakhon Pathom, Thailand A. Taweewongsounton Faculty of Medicine Ramathibodi Hospital, Research Center, Mahidol University, Bangkok, Thailand P. Niparuck Division of Hematology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
conducted genetic risk surveillance for IA among Thai hematologic patients. Methods: We conducted a prospective observational cohort study including moderate- to high-risk hematology patients at Ramathibodi Hospital. IA occurrence, relevant clinical data, and genetic analyses were assessed. Odds ratios (ORs) of IA were assessed for the presence of the selected single nucleotide polymorphism genotype using logistic regression. Results: A total of 357 patients were enrolled. The most common hematologic disease was non-Hodgkin lymphoma (45.1%). IA was diagnosed in 36 patients (10.10%). The C allele of IL10rs1800896 was associated with an increased risk of IA (adjusted OR 5.297; 95% confidence interval [CI] 2.032–13.809, p = 0.001). In multivariate Cox regression analysis, prolonged neutropenia and the C allele of IL10rs1800896 were associated with IA (hazard ratio [HR] 12.585; 95% CI 3.866–40.967, p \ 0.001 and HR 2.449; 95% CI 1.097–5.468, p = 0.042, respectively). Conclusions: Carrying the C allele of IL10rs1800896 was associated with an increased risk of IA among moderate- to high-risk Thai patients with hematologic diseases. This finding can potentially lead to a novel risk stratification scheme to further prevent IA in resource-limited settings.
Infect Dis Ther
Keywords: Antifungal prophylaxis; Genetic susceptibility; Hematology patients; Invasive aspergillosis Key Summary Points Why carry out this study? Hematology patients are at high risk for invasive aspergillosis. Universal antifungal prophylaxis is not feasible in a resource-limited setting even in high-risk patients. Genetic risk surveillance may assist i
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