Incidence of bacterial blood stream infections in patients with acute GVHD.

Autor: Wallis W; The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Gulbis AM; The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Wang T; Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA.; CIBMTR® (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI, USA., Lee CJ; Fred Hutchinson Cancer Center, Seattle, WA, USA., Sharma A; Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA., Williams KM; Aflac Cancer and Blood Disorders Center, Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA., Nishihori T; Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center, Tampa, FL, USA.; Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA., Prestidge T; Blood and Cancer Centre, Starship Children's Hospital, Auckland, New Zealand., Gowda L; Yale Cancer Center and Yale School of Medicine, New Haven, CT, USA., Byrne M; Tennessee Oncology, Nashville, TN, USA., Krem MM; Kansas City VA Medical Center, Kansas, MO, USA., MacMillan ML; Blood and Marrow Transplant Program, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA., Kitko CL; Division of Pediatric Hematology/Oncology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA., Pidala J; Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center, Tampa, FL, USA., Spellman SR; CIBMTR® (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, MN, USA., Lee SJ; CIBMTR® (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI, USA.; Fred Hutchinson Cancer Center, Seattle, WA, USA., Alousi AM; The University of Texas MD Anderson Cancer Center, Houston, TX, USA. aalousi@mdanderson.org.
Jazyk: angličtina
Zdroj: Bone marrow transplantation [Bone Marrow Transplant] 2024 Oct 18. Date of Electronic Publication: 2024 Oct 18.
DOI: 10.1038/s41409-024-02426-9
Abstrakt: Bacterial bloodstream infections (BSI) can be a substantial contributor to complications of GVHD treatment. The aim of this study was to determine the risk for BSI from neutrophil engraftment through day 100 post transplant in patients with acute GVHD (AGVHD) based on organ involvement and severity. Patients (n = 4064) who underwent an allogeneic hematopoietic stem cell transplant (HCT) reported to the CIBMTR registry were analyzed. Grade II-IV AGVHD occurred in 1607 (39.5%) patients and was associated with a greater day-100 incidence of post engraftment BSI than with grade 0/I (24.9 vs. 15.3%). Patients with grade III/IV AGVHD had the highest BSI risk (HR 2.45; 95% CI 1.99-3.0; p < 0.0001). Lower GI involvement increased BSI risk (HR 1.54; 95% CI 1.17-2.02; p = 0.0019). BSI post-engraftment through day 100 was associated with worse survival (HR 1.64, 95% CI 1.43-1.87; p < 0.001) and higher non-relapse mortality (NRM), (HR 2.22; 95% CI 1.91-2.59; p < 0.001). Those with stage III/IV GI involvement are at highest risk for BSI. Future studies evaluating novel methods for preventing BSI in these high risk populations are needed to reduce mortality associated with AGVHD.
(© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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