TY - JOUR
TI - Infectious complications following allogeneic stem cell transplantation by using anti-thymocyte globulin-based myeloablative conditioning regimens in children with hemoglobinopathies
AU - Goussetis, E.
AU - Efstathiou, E.
AU - Paisiou, A.
AU - Avgerinou, G.
AU - Zisaki, K.
AU - Giamouris, V.J.
AU - Peristeri, I.
AU - Kitra, V.
AU - Vessalas, G.
AU - Gamaletsou, M.N.
AU - Sipsas, N.V.
AU - Graphakos, S.
JO - Transplant Infectious Disease
PY - 2015
VL - 17
TODO - 2
SP - 201-207
PB - Blackwell Publishing Inc.
SN - 1398-2273, 1399-3062
TODO - 10.1111/tid.12358
TODO - aciclovir;  amphotericin B lipid complex;  busulfan;  ciprofloxacin;  cotrimoxazole;  cyclophosphamide;  cyclosporin;  fluconazole;  fludarabine;  foscarnet;  ganciclovir;  methotrexate;  penicillin V;  pentamidine;  thymocyte antibody;  cyclosporin;  immunosuppressive agent;  lymphocyte antibody, adolescent;  allogeneic stem cell transplantation;  antibiotic prophylaxis;  Article;  bacteremia;  beta thalassemia;  blood culture;  child;  cytomegalovirus infection;  death;  disease free survival;  female;  graft failure;  graft rejection;  graft versus host reaction;  hemorrhagic cystitis;  herpes zoster;  human;  immunosuppressive treatment;  incidence;  infection rate;  infection risk;  infectious complication;  major clinical study;  male;  myeloablative conditioning;  neutropenia;  outcome assessment;  overall survival;  peripheral blood stem cell;  Pneumocystis pneumonia;  priority journal;  risk assessment;  sickle cell anemia;  systemic mycosis;  thrombocyte transfusion;  toxoplasmosis;  umbilical cord blood;  viremia;  adverse effects;  Anemia, Sickle Cell;  bacteremia;  beta-Thalassemia;  cohort analysis;  cystitis;  Cytomegalovirus Infections;  Graft vs Host Disease;  hematopoietic stem cell transplantation;  herpes zoster;  immunocompromized patient;  immunology;  infection;  Pneumonia, Pneumocystis;  procedures;  retrospective study;  toxoplasmosis;  viremia, Adolescent;  Anemia, Sickle Cell;  Antilymphocyte Serum;  Bacteremia;  beta-Thalassemia;  Child;  Cohort Studies;  Cyclosporine;  Cystitis;  Cytomegalovirus Infections;  Female;  Graft vs Host Disease;  Hematopoietic Stem Cell Transplantation;  Herpes Zoster;  Humans;  Immunocompromised Host;  Immunosuppressive Agents;  Infection;  Male;  Pneumonia, Pneumocystis;  Retrospective Studies;  Toxoplasmosis;  Transplantation Conditioning;  Viremia
TODO - Background: Anti-thymocyte globulin (ATG) has been used to prevent graft failure/rejection in the setting of allogeneic stem cell transplantation (allo-SCT) for hemoglobinopathies; however, epidemiology data for transplant-related infections in this population are scarce. Method: We retrospectively analyzed the epidemiology of bacterial, fungal, viral, and parasitic infections in a cohort of 105 children and adolescents with β-thalassemia (n = 100) or sickle cell disease (n = 5) who underwent allo-SCT using human leukocyte antigen (HLA)-identical sibling (n = 96) or HLA-compatible unrelated donors (n = 9) in a single institution. All patients received an ATG-based conditioning regimen. Results: The cumulative incidence of cytomegalovirus (CMV) viremia was 45.7% (95% confidence interval [CI] 33-55%), developing at a median of 48 (range 12-142) days without evidence of overt CMV disease. Herpes zoster developed in 8 patients at a median of 12 months post transplant, while 10 patients presented with late onset hemorrhagic cystitis at a median of 35 days post transplant. The cumulative incidence of bacteremia was 17.1% (95% CI 10.6-25%), occurring at a median of 74 (range 24-110) days. No patient developed probable or definite invasive fungal infection. Four deaths were recorded; 2 of them were attributed to infections (toxoplasmosis and Pneumocystis jirovecii pneumonia, respectively). Conclusion: The rate of infections after allo-SCT, using an ATG-containing preparative regimen, in our population of pediatric patients with hemoglobinopathies is comparable to that reported elsewhere with the use of non-ATG containing regimens. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
ER -