Infectious complications after second allogeneic hematopoietic cell transplant in adult patients with hematological malignancies
We conducted a retrospective review of the infectious complications and outcomes over a 2-year follow-up period of adult patients who received a second allogeneic hematopoietic cell transplant (2nd allo-HCT) during a five-year period at two cancer centers in Michigan. Sixty patients, of whom 44 (73%...
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| Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2022-12, Vol.57 (12), p.1820-1826 |
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| creator | Maurer, Stephen M. Linder, Kathleen A. Kauffman, Carol A. McDonald, Philip J. Arcobello, Jonathan Velasco, Jon Chandrasekar, Pranatharthi H. Revankar, Sanjay G. Miceli, Marisa H. |
| description | We conducted a retrospective review of the infectious complications and outcomes over a 2-year follow-up period of adult patients who received a second allogeneic hematopoietic cell transplant (2nd allo-HCT) during a five-year period at two cancer centers in Michigan. Sixty patients, of whom 44 (73%) had acute leukemia or myelodysplastic syndrome, were studied. The majority (
n
= 37,62%) received a 2nd allo-HCT because of relapsed leukemia. Infection episodes after the 2nd allo-HCT totaled 112. Bacteria were identified in 76 episodes, the majority of which occurred pre-engraftment. The most common infecting organisms were
Enterococcus
species and
Clostridioides difficile
. Viral infections, predominantly cytomegalovirus, accounted for 59 infection episodes and occurred mostly in pre-engraftment and early post-engraftment periods. There were 16 proven/probable fungal infections, of which 9 were invasive aspergillosis or candidiasis. Mortality was 45% (
n
= 27) at one year and 65% (
n
= 39) at 2 years after transplant, and 16 deaths (41%) were due to infection. Of those 16 infection deaths, 8 were bacterial, 4 fungal, 2 both bacterial and fungal, and 2 viral. Failure to engraft neutrophils or platelets was significantly associated with decreased survival,
p
|
| doi_str_mv | 10.1038/s41409-022-01827-y |
| format | Article |
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n
= 37,62%) received a 2nd allo-HCT because of relapsed leukemia. Infection episodes after the 2nd allo-HCT totaled 112. Bacteria were identified in 76 episodes, the majority of which occurred pre-engraftment. The most common infecting organisms were
Enterococcus
species and
Clostridioides difficile
. Viral infections, predominantly cytomegalovirus, accounted for 59 infection episodes and occurred mostly in pre-engraftment and early post-engraftment periods. There were 16 proven/probable fungal infections, of which 9 were invasive aspergillosis or candidiasis. Mortality was 45% (
n
= 27) at one year and 65% (
n
= 39) at 2 years after transplant, and 16 deaths (41%) were due to infection. Of those 16 infection deaths, 8 were bacterial, 4 fungal, 2 both bacterial and fungal, and 2 viral. Failure to engraft neutrophils or platelets was significantly associated with decreased survival,
p
< 0.0001 and
p
< 0.001, respectively. Infections are common after a 2nd allo-HCT and are associated with a high mortality rate.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/s41409-022-01827-y</identifier><identifier>PMID: 36151368</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>631/532/1542 ; 692/699/255 ; Aspergillosis ; Bacteria ; Candidiasis ; Cell Biology ; Complications ; Cytomegalovirus ; Fatalities ; Fungi ; Hematology ; Infections ; Internal Medicine ; Leukemia ; Leukocytes (neutrophilic) ; Malignancy ; Medicine ; Medicine & Public Health ; Mortality ; Myelodysplastic syndrome ; Myelodysplastic syndromes ; Public Health ; Stem cell transplantation ; Stem Cells ; Viral infections</subject><ispartof>Bone marrow transplantation (Basingstoke), 2022-12, Vol.57 (12), p.1820-1826</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Limited 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>The Author(s), under exclusive licence to Springer Nature Limited 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-8dee88716f4ebee1e4ff6d89f8ab075b64215e3e2f9f580b4fe8c128eb7f21d13</citedby><cites>FETCH-LOGICAL-c451t-8dee88716f4ebee1e4ff6d89f8ab075b64215e3e2f9f580b4fe8c128eb7f21d13</cites><orcidid>0000-0002-3175-0512</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41409-022-01827-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41409-022-01827-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Maurer, Stephen M.</creatorcontrib><creatorcontrib>Linder, Kathleen A.</creatorcontrib><creatorcontrib>Kauffman, Carol A.</creatorcontrib><creatorcontrib>McDonald, Philip J.</creatorcontrib><creatorcontrib>Arcobello, Jonathan</creatorcontrib><creatorcontrib>Velasco, Jon</creatorcontrib><creatorcontrib>Chandrasekar, Pranatharthi H.</creatorcontrib><creatorcontrib>Revankar, Sanjay G.</creatorcontrib><creatorcontrib>Miceli, Marisa H.</creatorcontrib><title>Infectious complications after second allogeneic hematopoietic cell transplant in adult patients with hematological malignancies</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><description>We conducted a retrospective review of the infectious complications and outcomes over a 2-year follow-up period of adult patients who received a second allogeneic hematopoietic cell transplant (2nd allo-HCT) during a five-year period at two cancer centers in Michigan. Sixty patients, of whom 44 (73%) had acute leukemia or myelodysplastic syndrome, were studied. The majority (
n
= 37,62%) received a 2nd allo-HCT because of relapsed leukemia. Infection episodes after the 2nd allo-HCT totaled 112. Bacteria were identified in 76 episodes, the majority of which occurred pre-engraftment. The most common infecting organisms were
Enterococcus
species and
Clostridioides difficile
. Viral infections, predominantly cytomegalovirus, accounted for 59 infection episodes and occurred mostly in pre-engraftment and early post-engraftment periods. There were 16 proven/probable fungal infections, of which 9 were invasive aspergillosis or candidiasis. Mortality was 45% (
n
= 27) at one year and 65% (
n
= 39) at 2 years after transplant, and 16 deaths (41%) were due to infection. Of those 16 infection deaths, 8 were bacterial, 4 fungal, 2 both bacterial and fungal, and 2 viral. Failure to engraft neutrophils or platelets was significantly associated with decreased survival,
p
< 0.0001 and
p
< 0.001, respectively. Infections are common after a 2nd allo-HCT and are associated with a high mortality rate.</description><subject>631/532/1542</subject><subject>692/699/255</subject><subject>Aspergillosis</subject><subject>Bacteria</subject><subject>Candidiasis</subject><subject>Cell Biology</subject><subject>Complications</subject><subject>Cytomegalovirus</subject><subject>Fatalities</subject><subject>Fungi</subject><subject>Hematology</subject><subject>Infections</subject><subject>Internal Medicine</subject><subject>Leukemia</subject><subject>Leukocytes (neutrophilic)</subject><subject>Malignancy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Myelodysplastic syndrome</subject><subject>Myelodysplastic syndromes</subject><subject>Public Health</subject><subject>Stem cell transplantation</subject><subject>Stem Cells</subject><subject>Viral 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malignancies</atitle><jtitle>Bone marrow transplantation (Basingstoke)</jtitle><stitle>Bone Marrow Transplant</stitle><date>2022-12-01</date><risdate>2022</risdate><volume>57</volume><issue>12</issue><spage>1820</spage><epage>1826</epage><pages>1820-1826</pages><issn>0268-3369</issn><eissn>1476-5365</eissn><abstract>We conducted a retrospective review of the infectious complications and outcomes over a 2-year follow-up period of adult patients who received a second allogeneic hematopoietic cell transplant (2nd allo-HCT) during a five-year period at two cancer centers in Michigan. Sixty patients, of whom 44 (73%) had acute leukemia or myelodysplastic syndrome, were studied. The majority (
n
= 37,62%) received a 2nd allo-HCT because of relapsed leukemia. Infection episodes after the 2nd allo-HCT totaled 112. Bacteria were identified in 76 episodes, the majority of which occurred pre-engraftment. The most common infecting organisms were
Enterococcus
species and
Clostridioides difficile
. Viral infections, predominantly cytomegalovirus, accounted for 59 infection episodes and occurred mostly in pre-engraftment and early post-engraftment periods. There were 16 proven/probable fungal infections, of which 9 were invasive aspergillosis or candidiasis. Mortality was 45% (
n
= 27) at one year and 65% (
n
= 39) at 2 years after transplant, and 16 deaths (41%) were due to infection. Of those 16 infection deaths, 8 were bacterial, 4 fungal, 2 both bacterial and fungal, and 2 viral. Failure to engraft neutrophils or platelets was significantly associated with decreased survival,
p
< 0.0001 and
p
< 0.001, respectively. Infections are common after a 2nd allo-HCT and are associated with a high mortality rate.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>36151368</pmid><doi>10.1038/s41409-022-01827-y</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-3175-0512</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SpringerLink Journals - AutoHoldings |
| subjects | 631/532/1542 692/699/255 Aspergillosis Bacteria Candidiasis Cell Biology Complications Cytomegalovirus Fatalities Fungi Hematology Infections Internal Medicine Leukemia Leukocytes (neutrophilic) Malignancy Medicine Medicine & Public Health Mortality Myelodysplastic syndrome Myelodysplastic syndromes Public Health Stem cell transplantation Stem Cells Viral infections |
| title | Infectious complications after second allogeneic hematopoietic cell transplant in adult patients with hematological malignancies |
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