Hematopoietic stem cell transplantation following invasive mold infection in chronic granulomatous disease: Insights from a case series and literature review

Chronic granulomatous disease (CGD) is an inborn error of immunity leading to severe invasive mold infections (IMIs). Questions remain regarding the safety of hematopoietic stem cell transplantation (HSCT) in patients following IMI. We retrospectively collected data from CGD patients undergoing HSCT within 2 years after a diagnosis of probable or proven IMI in France. The primary endpoint was to describe 1-year overall survival (OS). 14 patients were included, with aspergillosis (n = 10), mucormycosis (N = 2), scedosporiosis, or lomentosporiosis (n = 1 each). IMI status at time of HCST included four in complete response, four in partial response (PR), one in stable response (SR), and five with disease progression (DP). 1-year OS was 86 % (12/14). Two patients with scedosporiosis and lomentosporiosis died before engraftment. The remaining patients all achieved engraftment followed by prolonged clinical response of IMI. HSCT appears safe in patients with complete response or PR of IMI and could be a promising curative option for progressive IMI, specifically in those with invasive aspergillosis.