To evaluate risk factors for invasive mould infections (IMI) in adult patients with hematological malignancies and/or hematopoietic stem cell transplantation (HSCT). Systematic review from PubMed, Embase, CENTRAL, and grey literature (01/01/2002-23/01/2025). Eligible studies were cohort or case-control studies. Selection, data extraction, and bias assessment were performed in duplicate. Adjusted measure effects were pooled using random-effects models. From 13 372 references, 45 studies were included; 17 focused on any type of IMI (n=846), 26 specifically on invasive aspergillosis (IA, n=2 086) and 2 on mucormycosis (n=53). Twenty-eight studies (10 on IMI, 18 on IA) were eligible for meta-analysis. Relapsed/refractory hemopathies were significantly associated with a higher risk of IMI (HR 3.43 95%CI 1.58-7.46) whereas prolonged neutropenia was associated with IA (OR 4.85 95%CI 2.15-10.97). Specifically in the allo-HSCT population, both acute and chronic graft vs host disease (GvHD) (acute GvHD HR 3.23 95%CI 2.20-4.74; chronic GvHD HR 2.95 95%CI 1.25-6.96) were associated with IMI and CMV disease (HR 3.23 95%CI 1.00-10.43), and corticosteroid use (HR 4.67 95% CI2.79-7.82) were associated with IA. Recognizing risk factors for IMI in patients with hematological malignancy or HSCT is essential to improve prevention and management strategies.
Gras et al. (Fri,) studied this question.