Infections after allogeneic hematopoietic stem cell transplantation with a nonmyeloablative conditioning regimen.

Abstract:

:Hematopoietic cell transplantation (HCT) following nonmyeloablative conditioning (NMSCT) may be associated with a reduced risk of infection compared to standard allogeneic HCT. We retrospectively analyzed incidence and risk factors of infection in 62 patients undergoing NMSCT with low-dose TBI +/- fludarabine and postgrafting CsA and MMF. The proportion of patients with any infection was 77%, but the majority of infectious events occurred beyond day 30. Donor other than sibling, older age, early disease and male gender were significant risk factors. The incidence of bacteremia was 55% at 1 year and the number of bacteremic episodes was 0.9 per patient (0.08 before day 30). The risk of bacteremia increased with older age and the use of a donor other than an HLA-identical sibling, but not with neutropenia. The incidence of infections other than bacteremia correlated with the use of corticosteroids. The risk of CMV infection increased with high-risk CMV serology, and risk of CMV disease with high-risk CMV serology, older age, first transplantation and a diagnosis of lymphoma. In conclusion, after NMSCT, infections are not frequent in the first 30 days post transplant but careful long-term monitoring is necessary thereafter.

journal_name

Bone Marrow Transplant

authors

Frère P,Baron F,Bonnet C,Hafraoui K,Pereira M,Willems E,Fillet G,Beguin Y

doi

10.1038/sj.bmt.1705255

subject

Has Abstract

pub_date

2006-02-01 00:00:00

pages

411-8

issue

4

eissn

0268-3369

issn

1476-5365

pii

1705255

journal_volume

37

pub_type

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