Τίτλος:
Infectious complications following allogeneic stem cell transplantation by using anti-thymocyte globulin-based myeloablative conditioning regimens in children with hemoglobinopathies
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Goussetis, E.
Efstathiou, E.
Paisiou, A.
Avgerinou, G.
Zisaki, K.
Giamouris, V.J.
Peristeri, I.
Kitra, V.
Vessalas, G.
Gamaletsou, M.N.
Sipsas, N.V.
Graphakos, S.
Περιοδικό:
Transplant Infectious Disease
Εκδότης:
Blackwell Publishing Inc.
Λέξεις-κλειδιά:
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
