1463Immune Reconstitution Inflammatory Syndrome (IRIS) in Neutropenic Patients with Invasive Pulmonary Aspergillosis (IPA) during Neutrophil Recovery

Background. Limited data on the incidence and clinical characteristics of IRIS in neutropenic patients with IPA were available. Methods. During 6-year period, adult patients with neutropenia who met probable or proven IPA by the EORTC criteria were retrospectively enrolled. IRIS was defined as new appearance or worsening of radiologic pulmonary findings temporally related to neutrophil recovery with evidence of a decrease 50% in serum galactomannan index titers. Results. Of 150 patients, 35 (23%, 95% CI 17% 31%) developed IRIS during neutrophil recovery. IRIS was associated with shorter neutropenic period, controlled underlying hematologic disease, less immunosuppressant use, and voriconazole use (table). The 30and 90-day mortalities were lower in patients with IRIS than those with nonIRIS (table). In the subgroup analysis of 53 patients who had progressive disease during the neutrophil recovery, 35 (66%, 95% CI 53% -77%) were classified as IRIS group. The 30and 90-day mortalities was higher in patients with non-IRIS who had progressive disease during the neutrophil recovery than in those with IRIS (9% vs 39%, P = 0.02 and 31% vs 72%, P = 0.005, respectively).