Invasive Pulmonary Aspergillosis: Comparative Analysis in Cancer Patients with Underlying Haematologic Malignancies Versus Solid Tumors

Summary Background Invasive pulmonary aspergillosis (IPA) is commonly associated with haematologic malignancies but also occurs with solid tumors. Aim Comparing the diagnostic approaches and therapeutic outcomes for IPA between patients with haematologic malignancies and solid cancers. Methods We conducted a retrospective study evaluating consecutive cases of proven and probable IPA from 2004 to 2016. We included patients >18 years old with an underlying solid tumor, haematologic malignancy, or haematopoietic cell transplantation (HCT) within 1 year of IPA diagnosis. Findings Of the 311 patients analyzed, 225 had haematologic malignancies and 86 had solid tumors. Patients with solid tumors were more likely to have had COPD or other pulmonary diseases, have Aspergillus fumigatus infections, and have received radiotherapy before IPA occurrence than were those with haematologic malignancies (all P Conclusions Monotherapy was more often prescribed in patients with solid tumors than patients with haematologic malignancies. Patients with solid tumors had better antifungal therapy response and lower 12-week IPA-attributable mortality than did those with haematologic malignancies.