Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation

Celalettin Ustun, Jo Anne H. Young, Genovefa A. Papanicolaou, Soyoung Kim, Kwang Woo Ahn, Min Chen, Hisham Abdel-Azim, Mahmoud Aljurf, Amer Beitinjaneh, Valerie Brown, Jan Cerny, Saurabh Chhabra, Mohamed A. Kharfan-Dabaja, Parastoo B. Dahi, Andrew Daly, Christopher E. Dandoy, Christopher C. Dvorak, Cesar O. Freytes, Shahrukh Hashmi, Hillard LazarusPer Ljungman, Taiga Nishihori, Kristin Page, Sai R.K. Pingali, Ayman Saad, Bipin N. Savani, Daniel Weisdorf, Kirsten Williams, Baldeep Wirk, Jeffery J. Auletta, Caroline A. Lindemans, Krishna Komanduri, Marcie Riches

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1254-1265
Number of pages12
JournalBone Marrow Transplantation
Volume54
Issue number8
DOIs
StatePublished - Aug 1 2019

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Ustun, C., Young, J. A. H., Papanicolaou, G. A., Kim, S., Ahn, K. W., Chen, M., Abdel-Azim, H., Aljurf, M., Beitinjaneh, A., Brown, V., Cerny, J., Chhabra, S., Kharfan-Dabaja, M. A., Dahi, P. B., Daly, A., Dandoy, C. E., Dvorak, C. C., Freytes, C. O., Hashmi, S., ... Riches, M. (2019). Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation. Bone Marrow Transplantation, 54(8), 1254-1265. https://doi.org/10.1038/s41409-018-0401-4