Invasive pulmonary aspergillosis in patients with solid tumours: risk factors and predictors of clinical outcomes

AbstractBackground: The characteristics and management of invasive pulmonary aspergillosis (IPA) in patients with hematologic malignancies are well known, but IPA in patients with solid tumours is not well described.Methods: We retrospectively reviewed all Aspergillus-positive cultures at a tertiary cancer center during 2004–2017. We identified 101 patients with IPA and solid tumours. We analyzed the association between clinical features and treatment and 12-week mortality and response to antifungal therapy.Results: Fifty-one patients had lung cancer, 77 had underlying lung disease, 47 received chest radiation and 33 had chronic obstructive pulmonary disease. Aspergillus fumigatus was the most common type isolated (71%); 68 patients (70%) were treated with voriconazole monotherapy. Independent risk factors for 12-week mortality included receiving steroids within 30 days of diagnosis (hazard ratio 2.2, 95% confidence interval [CI]: 1.1–4.6; p = .03) and chest radiotherapy (hazard ratio 2.6, 95% CI: 1.2–5.5...