Routine Infectious Disease Consultation Prior to an Allogeneic Hematopoietic Cell Transplant

Abstract Background A transplant infectious disease (TID) assessment is essential to select recipients for an allogeneic hematopoietic cell transplant (HCT) and tailor prophylactic and empirical treatment recommendations. Methods We performed a retrospective single-center study to describe our model...

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Veröffentlicht in:Open Forum Infectious Diseases 2023-12, Vol.10 (12), p.ofad578-ofad578
Hauptverfasser: Portillo, Vera, Masouridi-Levrat, Stavroula, Chalandon, Yves, Mappoura, Maria, Morin, Sarah, Marinosci, Annalisa, Giannotti, Federica, Mamez, Anne-Claire, van Delden, Christian, Neofytos, Dionysios
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container_end_page ofad578
container_issue 12
container_start_page ofad578
container_title Open Forum Infectious Diseases
container_volume 10
creator Portillo, Vera
Masouridi-Levrat, Stavroula
Chalandon, Yves
Mappoura, Maria
Morin, Sarah
Marinosci, Annalisa
Giannotti, Federica
Mamez, Anne-Claire
van Delden, Christian
Neofytos, Dionysios
description Abstract Background A transplant infectious disease (TID) assessment is essential to select recipients for an allogeneic hematopoietic cell transplant (HCT) and tailor prophylactic and empirical treatment recommendations. Methods We performed a retrospective single-center study to describe our model of care based on a routine TID consultation prior to an allogeneic HCT between 2018 and 2022 in 292 adult (≥18-year-old) consecutive patients. We describe the performance of a TID consultation, arbitrarily defined as major (HCT postponement, procedure, cytomegalovirus [CMV] recipient serology reinterpretation) and minor interventions. Results Overall, 765 interventions were observed in 257 of 292 (88%) patients: 88 of 765 (11.5%) major and 677 of 765 (88.5%) minor interventions. Among major interventions, HCT was postponed in 8 of 292 (2.7%) patients and a procedure was requested in 18 of 292 (6.2%) patients. The CMV recipient serostatus was changed from indeterminate/low-titer positive to negative in 60 of 292 (20.5%) patients. Among 677 minor interventions, there were 68 (8.8%) additional consultations with other services requested, 260 (33.7%) additional diagnostic tests requested, 102 (13.2%) additional treatments recommended, 60 (7.8%) non-CMV serology reinterpretations performed, 115 (14.9%) deviations from routine anti-infective prophylaxis, and 72 (9.3%) deviations from routine empirical antibiotic treatment recommendations in case of neutropenic fever. Conclusions We are proposing a structured, clearly defined, and comprehensive pretransplant checklist for an effective assessment of infectious disease risks and complications prior to an allogeneic HCT. Further studies or experiences like ours could help to define a global strategy or new models of care to be implemented in HCT centers in the future.
doi_str_mv 10.1093/ofid/ofad578
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Methods We performed a retrospective single-center study to describe our model of care based on a routine TID consultation prior to an allogeneic HCT between 2018 and 2022 in 292 adult (≥18-year-old) consecutive patients. We describe the performance of a TID consultation, arbitrarily defined as major (HCT postponement, procedure, cytomegalovirus [CMV] recipient serology reinterpretation) and minor interventions. Results Overall, 765 interventions were observed in 257 of 292 (88%) patients: 88 of 765 (11.5%) major and 677 of 765 (88.5%) minor interventions. Among major interventions, HCT was postponed in 8 of 292 (2.7%) patients and a procedure was requested in 18 of 292 (6.2%) patients. The CMV recipient serostatus was changed from indeterminate/low-titer positive to negative in 60 of 292 (20.5%) patients. Among 677 minor interventions, there were 68 (8.8%) additional consultations with other services requested, 260 (33.7%) additional diagnostic tests requested, 102 (13.2%) additional treatments recommended, 60 (7.8%) non-CMV serology reinterpretations performed, 115 (14.9%) deviations from routine anti-infective prophylaxis, and 72 (9.3%) deviations from routine empirical antibiotic treatment recommendations in case of neutropenic fever. Conclusions We are proposing a structured, clearly defined, and comprehensive pretransplant checklist for an effective assessment of infectious disease risks and complications prior to an allogeneic HCT. Further studies or experiences like ours could help to define a global strategy or new models of care to be implemented in HCT centers in the future.</description><identifier>ISSN: 2328-8957</identifier><identifier>EISSN: 2328-8957</identifier><identifier>DOI: 10.1093/ofid/ofad578</identifier><identifier>PMID: 38088980</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Communicable diseases ; Evidence-based medicine ; Hematopoietic stem cells ; Major ; Metronidazole ; Posaconazole ; Tazobactam ; Transplantation</subject><ispartof>Open Forum Infectious Diseases, 2023-12, Vol.10 (12), p.ofad578-ofad578</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. 2023</rights><rights>The Author(s) 2023. 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Methods We performed a retrospective single-center study to describe our model of care based on a routine TID consultation prior to an allogeneic HCT between 2018 and 2022 in 292 adult (≥18-year-old) consecutive patients. We describe the performance of a TID consultation, arbitrarily defined as major (HCT postponement, procedure, cytomegalovirus [CMV] recipient serology reinterpretation) and minor interventions. Results Overall, 765 interventions were observed in 257 of 292 (88%) patients: 88 of 765 (11.5%) major and 677 of 765 (88.5%) minor interventions. Among major interventions, HCT was postponed in 8 of 292 (2.7%) patients and a procedure was requested in 18 of 292 (6.2%) patients. The CMV recipient serostatus was changed from indeterminate/low-titer positive to negative in 60 of 292 (20.5%) patients. Among 677 minor interventions, there were 68 (8.8%) additional consultations with other services requested, 260 (33.7%) additional diagnostic tests requested, 102 (13.2%) additional treatments recommended, 60 (7.8%) non-CMV serology reinterpretations performed, 115 (14.9%) deviations from routine anti-infective prophylaxis, and 72 (9.3%) deviations from routine empirical antibiotic treatment recommendations in case of neutropenic fever. Conclusions We are proposing a structured, clearly defined, and comprehensive pretransplant checklist for an effective assessment of infectious disease risks and complications prior to an allogeneic HCT. Further studies or experiences like ours could help to define a global strategy or new models of care to be implemented in HCT centers in the future.</description><subject>Communicable diseases</subject><subject>Evidence-based medicine</subject><subject>Hematopoietic stem cells</subject><subject>Major</subject><subject>Metronidazole</subject><subject>Posaconazole</subject><subject>Tazobactam</subject><subject>Transplantation</subject><issn>2328-8957</issn><issn>2328-8957</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNp9kctrXCEUxiW0JCHNruvirl10Uh_j6F2VYdo8INASkl1BvN7j1OLVW_UG8t_XMJOQbMoBH8ff-fCcD6H3lJxR0vEvyfmhLWYQUh2gY8aZWqhOyDcvzkfotJQ_hBBKiSCyO0RHXBGlOkWO0a-bNFcfAV9FB7b6NBf8zRcwBfAmxTKHalo24p_Zp4xrwibidQhpCxG8xZcwmpqm5KG22wZCwLfZxDIFE-s79NaZUOB0v5-gu_Pvt5vLxfWPi6vN-nphl0taF2wJjkpCre2s5JRRMBRYz9VKccFXlAsLDHroezEIJ60zoHrqGGPCGtU5foK-7nSnuR9hsBBrNkFP2Y8mP-hkvH79Ev1vvU33mhJJhZSrpvBpr5DT3xlK1aMvtnVjIrSRaNYR1sk2PdLQsx26NQG0jy41SdtigNHbFMH5ll9LRVswRVvB512BzamUDO75Y5ToRxf1o4t672LDP7xs5hl-8qwBH3dAmqf_S_0DTIapTQ</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Portillo, Vera</creator><creator>Masouridi-Levrat, Stavroula</creator><creator>Chalandon, Yves</creator><creator>Mappoura, Maria</creator><creator>Morin, Sarah</creator><creator>Marinosci, Annalisa</creator><creator>Giannotti, Federica</creator><creator>Mamez, Anne-Claire</creator><creator>van Delden, Christian</creator><creator>Neofytos, Dionysios</creator><general>Oxford University Press</general><scope>TOX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IAO</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6970-2869</orcidid><orcidid>https://orcid.org/0000-0001-9341-8104</orcidid></search><sort><creationdate>20231201</creationdate><title>Routine Infectious Disease Consultation Prior to an Allogeneic Hematopoietic Cell Transplant</title><author>Portillo, Vera ; Masouridi-Levrat, Stavroula ; Chalandon, Yves ; Mappoura, Maria ; Morin, Sarah ; Marinosci, Annalisa ; Giannotti, Federica ; Mamez, Anne-Claire ; van Delden, Christian ; Neofytos, Dionysios</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-24ef1701cc9c73121ea1e2b38683536135ce2ebebb5d5f7cfae8b1f2225ca89f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Communicable diseases</topic><topic>Evidence-based medicine</topic><topic>Hematopoietic stem cells</topic><topic>Major</topic><topic>Metronidazole</topic><topic>Posaconazole</topic><topic>Tazobactam</topic><topic>Transplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Portillo, Vera</creatorcontrib><creatorcontrib>Masouridi-Levrat, Stavroula</creatorcontrib><creatorcontrib>Chalandon, Yves</creatorcontrib><creatorcontrib>Mappoura, Maria</creatorcontrib><creatorcontrib>Morin, Sarah</creatorcontrib><creatorcontrib>Marinosci, Annalisa</creatorcontrib><creatorcontrib>Giannotti, Federica</creatorcontrib><creatorcontrib>Mamez, Anne-Claire</creatorcontrib><creatorcontrib>van Delden, Christian</creatorcontrib><creatorcontrib>Neofytos, Dionysios</creatorcontrib><collection>Access via Oxford University Press (Open Access Collection)</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale Academic OneFile</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Open Forum Infectious Diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Portillo, Vera</au><au>Masouridi-Levrat, Stavroula</au><au>Chalandon, Yves</au><au>Mappoura, Maria</au><au>Morin, Sarah</au><au>Marinosci, Annalisa</au><au>Giannotti, Federica</au><au>Mamez, Anne-Claire</au><au>van Delden, Christian</au><au>Neofytos, Dionysios</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Routine Infectious Disease Consultation Prior to an Allogeneic Hematopoietic Cell Transplant</atitle><jtitle>Open Forum Infectious Diseases</jtitle><addtitle>Open Forum Infect Dis</addtitle><date>2023-12-01</date><risdate>2023</risdate><volume>10</volume><issue>12</issue><spage>ofad578</spage><epage>ofad578</epage><pages>ofad578-ofad578</pages><issn>2328-8957</issn><eissn>2328-8957</eissn><abstract>Abstract Background A transplant infectious disease (TID) assessment is essential to select recipients for an allogeneic hematopoietic cell transplant (HCT) and tailor prophylactic and empirical treatment recommendations. Methods We performed a retrospective single-center study to describe our model of care based on a routine TID consultation prior to an allogeneic HCT between 2018 and 2022 in 292 adult (≥18-year-old) consecutive patients. We describe the performance of a TID consultation, arbitrarily defined as major (HCT postponement, procedure, cytomegalovirus [CMV] recipient serology reinterpretation) and minor interventions. Results Overall, 765 interventions were observed in 257 of 292 (88%) patients: 88 of 765 (11.5%) major and 677 of 765 (88.5%) minor interventions. Among major interventions, HCT was postponed in 8 of 292 (2.7%) patients and a procedure was requested in 18 of 292 (6.2%) patients. The CMV recipient serostatus was changed from indeterminate/low-titer positive to negative in 60 of 292 (20.5%) patients. Among 677 minor interventions, there were 68 (8.8%) additional consultations with other services requested, 260 (33.7%) additional diagnostic tests requested, 102 (13.2%) additional treatments recommended, 60 (7.8%) non-CMV serology reinterpretations performed, 115 (14.9%) deviations from routine anti-infective prophylaxis, and 72 (9.3%) deviations from routine empirical antibiotic treatment recommendations in case of neutropenic fever. Conclusions We are proposing a structured, clearly defined, and comprehensive pretransplant checklist for an effective assessment of infectious disease risks and complications prior to an allogeneic HCT. Further studies or experiences like ours could help to define a global strategy or new models of care to be implemented in HCT centers in the future.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>38088980</pmid><doi>10.1093/ofid/ofad578</doi><orcidid>https://orcid.org/0000-0001-6970-2869</orcidid><orcidid>https://orcid.org/0000-0001-9341-8104</orcidid><oa>free_for_read</oa></addata></record>
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subjects Communicable diseases
Evidence-based medicine
Hematopoietic stem cells
Major
Metronidazole
Posaconazole
Tazobactam
Transplantation
title Routine Infectious Disease Consultation Prior to an Allogeneic Hematopoietic Cell Transplant
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