BACTERIAL BLOOD STREAM INFECTIONS (BSI), PARTICULARLY POST-ENGRAFTMENT BSI, ARE ASSOCIATED WITH INCREASED MORTALITY AFTER ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANTATION

We analyzed CIBMTR data to evaluate the incidence of non-relapse mortality (NRM) and association with overall survival (OS) for Bacterial blood stream infections (BSIs) occurring within 100 days of alloHCT in 2 different phases: pre/peri engraftment (BSI very early phase, BSI-VEP) and BSI post engra...

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Detalles Bibliográficos
Autores principales: Ustun, Celalettin, Young, Jo-Anne H., Papanicolaou, Genovefa A., Kim, Soyoung, Ahn, Kwang Woo, Chen, Min, Abdel-Azim, Hisham, Aljurf, Mahmoud, Beitinjaneh, Amer, Brown, Valerie, Cerny, Jan, Chhabra, Saurabh, Kharfan-Dabaja, Mohamed A., Dahi, Parastoo B., Daly, Andrew, Dandoy, Christopher E., Dvorak, Christopher C., Freytes, Cesar O., Hashmi, Shahrukh, Lazarus, Hillard, Ljungman, Per, Nishihori, Taiga, Page, Kristin, Pingali, Sai RK, Saad, Ayman, Savani, Bipin N., Weisdorf, Daniel, Williams, Kirsten, Wirk, Baldeep, Auletta, Jeffery J., Lindemans, Caroline A., Komanduri, Krishna, Riches, Marcie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2018
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565512/
https://www.ncbi.nlm.nih.gov/pubmed/30546070
http://dx.doi.org/10.1038/s41409-018-0401-4
Descripción
Sumario:We analyzed CIBMTR data to evaluate the incidence of non-relapse mortality (NRM) and association with overall survival (OS) for Bacterial blood stream infections (BSIs) occurring within 100 days of alloHCT in 2 different phases: pre/peri engraftment (BSI very early phase, BSI-VEP) and BSI post engraftment (BSI occurring between 2 weeks after engraftment and Day100, late early phase, BSI-LEP). Of 7,128 alloHCT patients, 2,656 (37%) had ≥1 BSI by day100. BSI-VEP, BSI-LEP, BSI-Both constituted 56% (n=1492), 31% (n=824), and 13% (n=340) of total BSI, respectively. Starting in 2009 we observed a gradual decline in BSI incidence through 2012 (61% to 48%). Patients with BSI-VEP were more likely to receive a myeloablative conditioning (MAC) regimen with total body irradiation (TBI). NRM was significantly higher in patients with any BSI (RR 1.82 95CI 1.63–2.04 for BSI-VEP, RR 2.46, 95%CI 2.05–2.96 for BSI-LEP, and RR 2.29, 95%CI 1.87–2.81 for BSI-Both) compared with those without BSI. OS was significantly lower in patients with any BSI compared with patients without BSI (RR 1.36, 95%CI 1.26–1.47 for BSI-VEP; RR 1.83, 95%CI 1.58–2.12 for BSI-LEP: RR 1.66, 95%CI 1.43–1.94 for BSI-Both). BSIs within day100 after alloHCT are common and remain a risk factor for mortality.

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