TY - JOUR
T1 - Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation
AU - Ustun, Celalettin
AU - Young, Jo Anne H.
AU - Papanicolaou, Genovefa A.
AU - Kim, Soyoung
AU - Ahn, Kwang Woo
AU - Chen, Min
AU - Abdel-Azim, Hisham
AU - Aljurf, Mahmoud
AU - Beitinjaneh, Amer
AU - Brown, Valerie
AU - Cerny, Jan
AU - Chhabra, Saurabh
AU - Kharfan-Dabaja, Mohamed A.
AU - Dahi, Parastoo B.
AU - Daly, Andrew
AU - Dandoy, Christopher E.
AU - Dvorak, Christopher C.
AU - Freytes, Cesar O.
AU - Hashmi, Shahrukh
AU - Lazarus, Hillard
AU - Ljungman, Per
AU - Nishihori, Taiga
AU - Page, Kristin
AU - Pingali, Sai R.K.
AU - Saad, Ayman
AU - Savani, Bipin N.
AU - Weisdorf, Daniel
AU - Williams, Kirsten
AU - Wirk, Baldeep
AU - Auletta, Jeffery J.
AU - Lindemans, Caroline A.
AU - Komanduri, Krishna
AU - Riches, Marcie
N1 - Publisher Copyright:
© 2018, Springer Nature Limited.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - 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 day 100, late early phase, BSI-LEP). Of the 7128 alloHCT patients, 2656 (37%) had ≥1 BSI by day 100. BSI-VEP, BSI-LEP, and 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 (61–48%). 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 95% CI 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 day 100 after alloHCT are common and remain a risk factor for mortality.
AB - 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 day 100, late early phase, BSI-LEP). Of the 7128 alloHCT patients, 2656 (37%) had ≥1 BSI by day 100. BSI-VEP, BSI-LEP, and 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 (61–48%). 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 95% CI 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 day 100 after alloHCT are common and remain a risk factor for mortality.
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U2 - 10.1038/s41409-018-0401-4
DO - 10.1038/s41409-018-0401-4
M3 - Article
C2 - 30546070
AN - SCOPUS:85058447470
SN - 0268-3369
VL - 54
SP - 1254
EP - 1265
JO - Bone marrow transplantation
JF - Bone marrow transplantation
IS - 8
ER -