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Age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation: lesson from the nationwide study

Incidence and outcome of microbiologically documented bacterial/viral infections and invasive fungal disease (IFD) in children and adults after hematopoietic cell transplantation (HCT) were compared in 650 children and 3200 adults in multicenter cross-sectional nationwide study. Infections were diag...

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Autores principales: Czyżewski, Krzysztof, Styczyński, Jan, Giebel, Sebastian, Frączkiewicz, Jowita, Salamonowicz, Małgorzata, Zając-Spychala, Olga, Zaucha-Prażmo, Agnieszka, Drozd-Sokołowska, Joanna, Waszczuk-Gajda, Anna, Dybko, Jarosław, Mańko, Joanna, Zalas-Więcek, Patrycja, Gałązka, Przemysław, Wysocki, Mariusz, Kowalczyk, Jerzy, Wachowiak, Jacek, Goździk, Jolanta, Basak, Grzegorz W, Kałwak, Krzysztof, Adamska, Monika, Hus, Marek, Piekarska, Agnieszka, Sadowska-Klasa, Alicja, Mensah-Glanowska, Patrycja, Kyrcz-Krzemień, Sławomira, Biernat, Monika, Wierzbowska, Agnieszka, Rzepecki, Piotr, Tomaszewska, Agnieszka, Hałaburda, Kazimierz, Gil, Lidia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700048/
https://www.ncbi.nlm.nih.gov/pubmed/31321454
http://dx.doi.org/10.1007/s00277-019-03755-2
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author Czyżewski, Krzysztof
Styczyński, Jan
Giebel, Sebastian
Frączkiewicz, Jowita
Salamonowicz, Małgorzata
Zając-Spychala, Olga
Zaucha-Prażmo, Agnieszka
Drozd-Sokołowska, Joanna
Waszczuk-Gajda, Anna
Dybko, Jarosław
Mańko, Joanna
Zalas-Więcek, Patrycja
Gałązka, Przemysław
Wysocki, Mariusz
Kowalczyk, Jerzy
Wachowiak, Jacek
Goździk, Jolanta
Basak, Grzegorz W
Kałwak, Krzysztof
Adamska, Monika
Hus, Marek
Piekarska, Agnieszka
Sadowska-Klasa, Alicja
Mensah-Glanowska, Patrycja
Kyrcz-Krzemień, Sławomira
Biernat, Monika
Wierzbowska, Agnieszka
Rzepecki, Piotr
Tomaszewska, Agnieszka
Hałaburda, Kazimierz
Gil, Lidia
author_facet Czyżewski, Krzysztof
Styczyński, Jan
Giebel, Sebastian
Frączkiewicz, Jowita
Salamonowicz, Małgorzata
Zając-Spychala, Olga
Zaucha-Prażmo, Agnieszka
Drozd-Sokołowska, Joanna
Waszczuk-Gajda, Anna
Dybko, Jarosław
Mańko, Joanna
Zalas-Więcek, Patrycja
Gałązka, Przemysław
Wysocki, Mariusz
Kowalczyk, Jerzy
Wachowiak, Jacek
Goździk, Jolanta
Basak, Grzegorz W
Kałwak, Krzysztof
Adamska, Monika
Hus, Marek
Piekarska, Agnieszka
Sadowska-Klasa, Alicja
Mensah-Glanowska, Patrycja
Kyrcz-Krzemień, Sławomira
Biernat, Monika
Wierzbowska, Agnieszka
Rzepecki, Piotr
Tomaszewska, Agnieszka
Hałaburda, Kazimierz
Gil, Lidia
author_sort Czyżewski, Krzysztof
collection PubMed
description Incidence and outcome of microbiologically documented bacterial/viral infections and invasive fungal disease (IFD) in children and adults after hematopoietic cell transplantation (HCT) were compared in 650 children and 3200 adults in multicenter cross-sectional nationwide study. Infections were diagnosed in 60.8% children and 35.0% adults, including respectively 69.1% and 63.5% allo-HCT, and 33.1% and 20.8% auto-HCT patients. The incidence of bacterial infections was higher in children (36.0% vs 27.6%; p < 0.0001). Infections with Gram-negative bacteria were more frequent than Gram-positives in adults (64.6% vs 44.8%; p < 0.0001). Outcome of bacterial infections was better in children (95.5% vs 91.4%; p = 0.0011). The IFD incidence (25.3% vs 6.3%; p < 0.0001) and outcome (88.0% vs 74.9%; p < 0.0001) were higher in children. The incidence of viral infections was higher in children after allo-HCT (56.3% vs 29.3%; p < 0.0001), and auto-HCT (6.6% vs 0.8%; p < 0.0001). Outcome of viral infections was better in children (98.6% vs 92.3%; p = 0.0096). Infection-related mortality was 7.8% in children and 18.4% in adults (p < 0.0001). No child after auto-HCT died of infection. Adult age, mismatched transplants, acute leukemia, chronic GVHD, CMV reactivation, infection with Gram-negatives, and duration of infection > 21 days were risk factors for death from infection. In conclusion, pediatric patients have 2.9-fold higher incidence and 2.5-fold better outcome of infections than adults after HCT.
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spelling pubmed-67000482019-08-29 Age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation: lesson from the nationwide study Czyżewski, Krzysztof Styczyński, Jan Giebel, Sebastian Frączkiewicz, Jowita Salamonowicz, Małgorzata Zając-Spychala, Olga Zaucha-Prażmo, Agnieszka Drozd-Sokołowska, Joanna Waszczuk-Gajda, Anna Dybko, Jarosław Mańko, Joanna Zalas-Więcek, Patrycja Gałązka, Przemysław Wysocki, Mariusz Kowalczyk, Jerzy Wachowiak, Jacek Goździk, Jolanta Basak, Grzegorz W Kałwak, Krzysztof Adamska, Monika Hus, Marek Piekarska, Agnieszka Sadowska-Klasa, Alicja Mensah-Glanowska, Patrycja Kyrcz-Krzemień, Sławomira Biernat, Monika Wierzbowska, Agnieszka Rzepecki, Piotr Tomaszewska, Agnieszka Hałaburda, Kazimierz Gil, Lidia Ann Hematol Original Article Incidence and outcome of microbiologically documented bacterial/viral infections and invasive fungal disease (IFD) in children and adults after hematopoietic cell transplantation (HCT) were compared in 650 children and 3200 adults in multicenter cross-sectional nationwide study. Infections were diagnosed in 60.8% children and 35.0% adults, including respectively 69.1% and 63.5% allo-HCT, and 33.1% and 20.8% auto-HCT patients. The incidence of bacterial infections was higher in children (36.0% vs 27.6%; p < 0.0001). Infections with Gram-negative bacteria were more frequent than Gram-positives in adults (64.6% vs 44.8%; p < 0.0001). Outcome of bacterial infections was better in children (95.5% vs 91.4%; p = 0.0011). The IFD incidence (25.3% vs 6.3%; p < 0.0001) and outcome (88.0% vs 74.9%; p < 0.0001) were higher in children. The incidence of viral infections was higher in children after allo-HCT (56.3% vs 29.3%; p < 0.0001), and auto-HCT (6.6% vs 0.8%; p < 0.0001). Outcome of viral infections was better in children (98.6% vs 92.3%; p = 0.0096). Infection-related mortality was 7.8% in children and 18.4% in adults (p < 0.0001). No child after auto-HCT died of infection. Adult age, mismatched transplants, acute leukemia, chronic GVHD, CMV reactivation, infection with Gram-negatives, and duration of infection > 21 days were risk factors for death from infection. In conclusion, pediatric patients have 2.9-fold higher incidence and 2.5-fold better outcome of infections than adults after HCT. Springer Berlin Heidelberg 2019-07-18 2019 /pmc/articles/PMC6700048/ /pubmed/31321454 http://dx.doi.org/10.1007/s00277-019-03755-2 Text en © The Author(s) 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Czyżewski, Krzysztof
Styczyński, Jan
Giebel, Sebastian
Frączkiewicz, Jowita
Salamonowicz, Małgorzata
Zając-Spychala, Olga
Zaucha-Prażmo, Agnieszka
Drozd-Sokołowska, Joanna
Waszczuk-Gajda, Anna
Dybko, Jarosław
Mańko, Joanna
Zalas-Więcek, Patrycja
Gałązka, Przemysław
Wysocki, Mariusz
Kowalczyk, Jerzy
Wachowiak, Jacek
Goździk, Jolanta
Basak, Grzegorz W
Kałwak, Krzysztof
Adamska, Monika
Hus, Marek
Piekarska, Agnieszka
Sadowska-Klasa, Alicja
Mensah-Glanowska, Patrycja
Kyrcz-Krzemień, Sławomira
Biernat, Monika
Wierzbowska, Agnieszka
Rzepecki, Piotr
Tomaszewska, Agnieszka
Hałaburda, Kazimierz
Gil, Lidia
Age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation: lesson from the nationwide study
title Age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation: lesson from the nationwide study
title_full Age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation: lesson from the nationwide study
title_fullStr Age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation: lesson from the nationwide study
title_full_unstemmed Age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation: lesson from the nationwide study
title_short Age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation: lesson from the nationwide study
title_sort age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation: lesson from the nationwide study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700048/
https://www.ncbi.nlm.nih.gov/pubmed/31321454
http://dx.doi.org/10.1007/s00277-019-03755-2
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