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Infections Post Transplant

Early infections in adults undergoing matched related and matched unrelated/mismatched donor stem cell transplantation: a comparison of incidence

Bone Marrow Transplantation volume 30, pages 303–309 (2002)Cite this article

Abstract

We compared the incidence of early infectious complications between matched related (MR) and matched unrelated/mismatched (MU/MM) allogeneic stem cell transplant (allo-SCT) recipients in a single centre over a 6-year period in 214 consecutive adult patients. Early infections were defined as occurring from hospital admission for SCT until discharge. One hundred and fifty-nine patients received an allograft from MR donors and 55 patients received MU/MM allo-SCT. One hundred and eight of 214 patients had 147 episodes of fever. Ninety-three episodes (63%) were due to clinically or microbiologically documented infections and 54 episodes (37%) to fever not related to infection. Patients undergoing MU/MM transplantation tended to have more documented infections compared to recipients of MR allo-SCT (P = 0.06). Significantly more MU/MM transplant recipients had breakthrough infections with Herpes simplex virus type 1 (HSV-1, P = 0.003), and more CMV reactivation (P = 0.015). The mortality rate in all patients during hospitalisation post-SCT was 6.3% in MR and 18.2% in MU/MM allo-SCT recipients (P = 0.009). Early mortality was associated with infection in 70% of the patients, with a similar distribution between MR and MU/MM transplant recipients. However, MU/MM transplant recipients had significantly more early deaths due to toxic causes (P < 0.001). We conclude that early post-transplant MU/MM transplant recipients tend to have more documented infections, and have significantly more breakthrough infections with HSV-1 and more CMV reactivation. MU/MM transplant recipients are at higher risk of early mortality, especially due to toxic causes.

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Authors and Affiliations

  1. Department of Haematology, University Medical Centre, Utrecht, The Netherlands

    MGJ van Kraaij, LF Verdonck & AW Dekker

  2. Eijkman-Winkler Institute of Medical Microbiology, Infectious Disease and Inflammation, University Medical Centre, Utrecht, The Netherlands

    M Rozenberg-Arska

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  1. MGJ van Kraaij
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  2. LF Verdonck
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  3. M Rozenberg-Arska
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  4. AW Dekker
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van Kraaij, M., Verdonck, L., Rozenberg-Arska, M. et al. Early infections in adults undergoing matched related and matched unrelated/mismatched donor stem cell transplantation: a comparison of incidence. Bone Marrow Transplant 30, 303–309 (2002). https://doi.org/10.1038/sj.bmt.1703643

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