Citations 2
Incidence, Risk Factors, and Outcomes of Patients Who Develop Mucosal Barrier Injury–Laboratory Confirmed Bloodstream Infections in the First 100 Days After Allogeneic Hematopoietic Stem Cell Transplant
Dandoy, Christopher E. , Ahn, Kwang Woo , Brown, Valerie I. , Dvorak, Christopher C. , Farhadfar, Nosha , Ganguly, Siddartha, Hale, Gregory A., Hashmi, Shahrukh K. , Hematti, Peiman , Martino, Rodrigo , Nusrat, Roomi , Olsson, Richard F. , Rotz, Seth J. , Sung, Anthony D. , Lindemans, Caroline A. , Riches, Marcie , Olsson, Richard F , Martino, Rodrigo , Dvorak, Christopher C , Dandoy, Christopher E , Hematti, Peiman , Sung, Anthony D , Kim, Soyoung , Chen, Min , Ardura, Monica I. , Chhabra, Saurabh , Díaz, Miguel Ángel , Flagg, Aron , Nishihori, Taiga , Perales, Miguel‐Angel , Komanduri, Krishna V.
JAMA Network Open | January 8, 2020 | Volume: 3 | Issue: 1 | Pages: e1918668
Increased overall and bacterial infections following myeloablative allogeneic HCT for patients with AML in CR1
Üstün, Celalettin , Kim, Soyoung , Chen, Min , Beitinjaneh, Amer , Brown, Valerie I. , Daly, Andrew , Freytes, César O. , Ganguly, Siddhartha , Hashmi, Shahrukh K. , Hildebrandt, Gerhard , Olsson, Richard F. , Page, Kristin , Saad, Ayman , Seo, Sachiko , William, Basem M. , Wirk, Baldeep , Auletta, Jeffery J. , Lindemans, Caroline A. , Riches, Marcie , Freytes, Cesar O , Hashmi, Shahrukh K , Hildebrandt, Gerhard C , Lazarus, Hillard M , Nishihori, Taiga , Olsson, Richard F , Saad, Ayman , Yared, Jean A , Komanduri, Krishna V , Riches, Marcie L , William, Basem , Dahi, Parastoo B , Díaz, Miguel Ángel , Lazarus, Hillard M. , Nishihori, Taiga , Papanicolaou, Genovefa A. , Wingard, John R. , Yared, Jean A. , Perales, Miguel‐Angel , Komanduri, Krishna V. , Auletta, Jeffery J , Kim, Soyoung
Blood Advances | August 30, 2019 | Volume: 3 | Issue: 17 | Pages: 2525-2536
10.1182/bloodadvances.2019000226
Abstract Presumably, reduced-intensity/nonmyeloablative conditioning (RIC/NMA) for allogeneic hematopoietic cell transplantation (alloHCT) results in reduced infections compared with myeloablative conditioning (MAC) regimens; however, published evidence is limited. In this Center for International Blood and Marrow Transplant Research study, 1755 patients (aged ≥40 years) with acute myeloid leukemia in first complete remission were evaluated for infections occurring within 100 days after T-cell replete alloHCT. Patients receiving RIC/NMA (n = 777) compared with those receiving MAC (n = 978) were older and underwent transplantation more recently; however, the groups were similar regarding Karnofsky performance score, HCT–comorbidity index, and cytogenetic risk. One or more infections occurred in 1045 (59.5%) patients (MAC, 595 [61%]; RIC/NMA, 450 [58%]; P = .21) by day 100. The median time to initial infection after MAC conditioning occurred earlier (MAC, 15 days [range, <1-99 days]; RIC/NMA, 21 days [range, <1-100 days]; P < .001). Patients receiving MAC were more likely to experience at least 1 bacterial infection by day 100 (MAC, 46% [95% confidence interval (CI), 43-49]; RIC/NMA, 37% [95% CI, 34-41]; P = .0004), whereas at least a single viral infection was more prevalent in the RIC/NMA cohort (MAC, 34% [95% CI, 31-37]; RIC/NMA, 39% [95% CI, 36-42]; P = .046). MAC remained a risk factor for bacterial infections in multivariable analysis (relative risk, 1.44; 95% CI, 1.23-1.67; P < .0001). Moreover, the rate of any infection per patient-days at risk in the first 100 days (infection density) after alloHCT was greater for the MAC cohort (1.21; 95% CI, 1.11-1.32; P < .0001). RIC/NMA was associated with reduced infections, especially bacterial infections, in the first 100 days after alloHCT.