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Table 3 Predictors of response to primary therapy in patients with hematologic malignancy and aspergillosis

From: Treating invasive aspergillosis in patients with hematologic malignancy: diagnostic-driven approach versus empiric therapies

Variables Univariate analysis Multivariate analysis
Response
(n = 101)
N (%)
No-Response
(n = 241)
N (%)
p-value OR (95% CI) p-value
Age (years), median (range) 59 (14–81) 52 (16–86) 0.007  
Gender, male 60 (59) 143 (59) 0.99   
Diagnosis of invasive aspergillosis    0.024  
 Definite 22/100 (22) 83 (34)    
 Probable 78/100 (78) 158 (66)    
Type of IA infection a    < .001   < .0001
 Invasive pulmonary infection 84 (83) 202 (84)   0.12 (0.04, 0.34) (< .0001)
 Disseminated infection 1 (1) 24 (10)   0.02 (< 0.01, 0.16) (< .0001)
 Localized or sinus infection 16 (16) 15 (6)   Referent  
Type of cancer    0.03  
 Leukemia 66/98 (67) 189/240 (79)    
 Lymphoma 23/98 (23) 43/240 (18)    
 Myeloma 9/98 (9) 8/240 (3)    
Transplantation within 1 year prior to infection 34 (34) 98/240 (41) 0.21  
Type of transplantation within prior year    0.26   
 Allogeneic transplant 27/34 (79) 86/98 (88)    
 Autologous transplant 7/34 (21) 12/98 (12)    
Graft vs Host Disease (GVHD) 18/27 (67) 64/86 (74) 0.43  
Neutropenia (< 500 ANC) at onset of IA 31/94 (33) 126/237 (53) 0.001  
Persistent neutropenia 30/79 (38) 92/231 (40) 0.77   
Received immunotherapy 38/99 (38) 163/240 (68) < .0001  
Received WBC transfusion 5/100 (5) 50/240 (21) < .001 0.21 (0.05, 0.66) 0.005
Year of IA diagnosis/treatment    < .0001  
 1993–2004 32 (32) 154 (64)    
 2005–2016 69 (68) 87 (36)    
Prophylactic antifungal treatment prior to infection 23/100 (23) 89 (37) 0.013  
Breakthrough 22/23 (96) 76/88 (86) 0.30   
Primary therapy strategy    < .0001   < .0001
 Diagnostic-driven therapy with voriconazole 32 (32) 12 (5)   Referent  
 Empiric antifungal therapy without voriconazole 30 (30) 191 (79)   0.05 (0.02, 0.12) (< .0001)
 Empiric antifungal therapy with voriconazole 39 (39) 38 (16)   0.41 (0.16, 1.02) (0.06)
  1. aAll patients with more than one types of IA infections in this study had invasive pulmonary infection and were included in invasive pulmonary infection category in this analysis