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Risk of serious bloodstream infections is low in pediatric hematopoietic stem cell transplant (HSCT) recipients with fevers due to antithymocyte globulins and alemtuzumab

Bone Marrow Transplantation volume 51, pages 1510–1512 (2016)Cite this article

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Owing to their immunomodulatory effects, antithymocyte globulins and alemtuzumab, commonly referred to as serotherapy (ST), are a common component of allogeneic hematopoietic stem cell transplant (HSCT) conditioning regimens.1, 2 Although the majority of patients receiving ST develop fevers and other adverse events (AE), there are no well-established practice guidelines for the management of ST-related fevers. We hypothesize that few ST-related fevers represent true bloodstream infection (BSI) and propose an evidence-based approach to antibiotic use in this population.

After obtaining IRB approval, we retrospectively collected data on 94 children receiving ST at our institution between July 2012 and April 2015. Data included transplant characteristics, ST-related AE (ST-AE), use of antibiotics and positive blood cultures (BC) during ST.

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Authors and Affiliations

  1. Pediatric Allergy Immunology and Blood and Marrow Transplant Division, University of California San Francisco (UCSF) Benioff Children’s Hospital, San Francisco, CA, USA

    B Horn, S O'Kane, J T Wahlstrom, A Melton, M J Cowan & C C Dvorak

  2. Pediatric Infectious Diseases and Global Health Division, UCSF Benioff Children’s Hospital, San Francisco, CA, USA

    R L Wattier

Authors
  1. B Horn
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  2. S O'Kane
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  3. R L Wattier
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  4. J T Wahlstrom
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  5. A Melton
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  6. M J Cowan
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  7. C C Dvorak
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Correspondence to B Horn.

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Horn, B., O'Kane, S., Wattier, R. et al. Risk of serious bloodstream infections is low in pediatric hematopoietic stem cell transplant (HSCT) recipients with fevers due to antithymocyte globulins and alemtuzumab. Bone Marrow Transplant 51, 1510–1512 (2016). https://doi.org/10.1038/bmt.2016.157

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