{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T04:03:33Z","timestamp":1774497813880,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To reduce the risk of invasive aspergillosis (IA), air purification by high\u2010efficiency particulate air filtration and laminar air flow (HEPA\/LAF) is standard of care in allogeneic blood stem cell transplantation. Its use in non\u2010transplant haematological patients is inconsistent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We sought to assess the incidence and outcome of pulmonary IA in non\u2010transplant patients with life\u2010threatening neutropenia by comparing an ambient air hospitalisation period (2008\u20132011) with a subsequent HEPA\/LAF hospitalisation period (2012\u20132014).<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>We compared 204 consecutive patients with acute myeloid leukaemia, acute lymphoblastic leukaemia or aplastic anaemia completing 534 neutropenia\u2010related hospitalisations under ambient air conditions with 126 such patients completing 437 neutropenia\u2010related hospitalisations under HEPA\/LAF conditions. IA was defined using the 2008 EORTC\/MSG criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Within a 7\u2010year study period, we observed one \u2018proven\u2019, three \u2018probable\u2019 and 73 \u2018possible\u2019 IAs, most often during acute leukaemia remission induction. Their frequency rose with increasing duration of life\u2010threatening neutropenia (1\u201310\u2009days, 1.8%; &gt;40\u2009days, 35.2%) and concomitant severe anaemia (0\u2009days, 3.2%; &gt;20\u2009days, 31.0%). Multiple logistic regression revealed a strong correlation between IA incidence and hospitalisation under HEPA\/LAF conditions (odds ratio [OR], 0.368 [95% confidence interval, 0.207\u20130.654]; <jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.001) and duration of neutropenia (OR, 1.043 [1.023\u20131.062] per day; <jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.001) and anaemia (OR, 1.044 [1.008\u20131.081] per day; <jats:italic>p<\/jats:italic>\u00a0=\u2009.016). IA\u2010associated fatal outcomes were non\u2010significantly reduced under HEPA\/LAF (OR, 0.077 [0.005\u20131.151]; <jats:italic>p<\/jats:italic>\u00a0=\u2009.063). The protective effect of HEPA\/LAF was not seen under posaconazole prophylaxis (OR, 0.856 [0.376\u20131.950]; <jats:italic>p<\/jats:italic>\u00a0=\u2009.711).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Implementation of HEPA\/LAF was associated with a significant reduction in neutropenia\u2010related IA in non\u2010transplant haematological patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13576","type":"journal-article","created":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T13:05:41Z","timestamp":1676379941000},"page":"505-514","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Neutropenia\u2010related aspergillosis in non\u2010transplant haematological patients hospitalised under ambient air versus purified air conditions"],"prefix":"10.1111","volume":"66","author":[{"given":"Christina","family":"Friese","sequence":"first","affiliation":[{"name":"Department of Hematology University Hospital Essen, University of Duisburg\u2010Essen  Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Breuckmann","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology and Neuroradiology University Hospital Essen, University of Duisburg\u2010Essen  Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"H\u00fcttmann","sequence":"additional","affiliation":[{"name":"Department of Hematology University Hospital Essen, University of Duisburg\u2010Essen  Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lewin","family":"Eisele","sequence":"additional","affiliation":[{"name":"Department of Hematology University Hospital Essen, University of Duisburg\u2010Essen  Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4034-9472","authenticated-orcid":false,"given":"Ulrich","family":"D\u00fchrsen","sequence":"additional","affiliation":[{"name":"Department of Hematology University Hospital Essen, University of Duisburg\u2010Essen  Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,2,23]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"3221","article-title":"European guidelines for primary antifungal prophylaxis in adult haematology patients: summary of the updated recommendations from the European conference on infections in Leukaemia","volume":"73","author":"Maertens JA","year":"2018","journal-title":"J Antimicrob 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