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Post-Transplant Events

Fewer infections and lower infection-related mortality following non-myeloablative versus myeloablative conditioning for allotransplantation of patients with lymphoma

Bone Marrow Transplantation volume 43, pages 237–244 (2009)Cite this article

Abstract

Non-myeloablative (NMA) allogeneic donor SCT for patients with relapsed lymphoma is associated with lower treatment-related mortality (TRM). However, the impact of conditioning intensity on post transplant infections remains unclear. We evaluated infections in 141 consecutive patients with lymphoma who were allografted using NMA (n=76) or myeloablative (MA; n=65) conditioning regimens. Using infection incidence density per 1000 patient days, we accounted for all infectious episodes during the first post transplant year. Before neutrophil engraftment, the NMA cohort had a 53% lower rate of bacterial infection (relative risk=0.47; P=0.06), whereas after engraftment the density of bacterial infections was similar in the two groups. In the first month, both invasive fungal infections and viral infections were twofold less frequent (P=0.22; P=0.06) in NMA patients. Late viral and fungal infections as well as CMV reactivation were infrequent after either conditioning intensity. The 1-year infection-related mortality was significantly lower after NMA conditioning (NMA 9% (3–16%) vs MA 22% (11–40%); P=0.03). NMA allogeneic transplantation for lymphoma patients results in substantially fewer early infections and lower infection-related deaths, although the similar frequency of later infections suggests that immune reconstitution is delayed with either conditioning intensity.

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Authors and Affiliations

  1. Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA

    V Bachanova, C G Brunstein, L J Burns, J S Miller, X Luo, T Defor, D J Weisdorf & M Tomblyn

  2. Division of Infectious Disease, Department of Medicine, University of Minnesota, Minneapolis, MN, USA

    J-Ah Young

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  1. V Bachanova
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  2. C G Brunstein
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  3. L J Burns
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Correspondence to V Bachanova.

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Bachanova, V., Brunstein, C., Burns, L. et al. Fewer infections and lower infection-related mortality following non-myeloablative versus myeloablative conditioning for allotransplantation of patients with lymphoma. Bone Marrow Transplant 43, 237–244 (2009). https://doi.org/10.1038/bmt.2008.313

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