Post-Transplant Complications

Bone Marrow Transplantation (2004) 34, 497–504. doi:10.1038/sj.bmt.1704636 Published online 2 August 2004

Infectious complications and outcomes after allogeneic hematopoietic stem cell transplantation in Korea

Part of this study was presented at the 29th World Congress of the International Society of Hematology (August-24–28, 2002), Seoul, South Korea.

J-H Yoo1, D-G Lee1, S M Choi1, J-H Choi1, Y-H Park1, Y-J Kim1, H-J Kim1, S Lee1, D-W Kim1, J-W Lee1, W-S Min1, W-S Shin1 and C-C Kim1

1Department of Internal Medicine, The Catholic Hematopoietic Stem Cell Transplantion Center, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence: Dr J-H Yoo, Department of Internal Medicine, Holy Family Hospital, Sosa-dong, Wonmi-Gu, Pucheon city 420-717, Kyounggi-District, South Korea. E-mail: jhyoo@catholic.ac.kr

Received 8 January 2004; Accepted 21 May 2004; Published online 2 August 2004.

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Abstract

We reviewed 242 allogeneic hematopoietic stem cell transplantation (HSCT) recipients retrospectively over a 2-year period (January 1998–December 1999) in order to analyze the characteristics and assess the outcomes of infectious complications in patients after HSCT in Korea. Bacteria were the major pathogens before engraftment, and viral and fungal infections predominated during the post-engraftment period. Varicella zoster virus was the most common viral pathogen after engraftment. Cytomegalovirus disease occurred mainly in the late-recovery phase. The frequency of mold infection was higher than that of yeast. There was a relatively high incidence of tuberculosis (3.0%) and Pneumocystis carinii pneumonia (6.5%). One case of death by measles confirmed by autopsy was also noted. Overall, cumulative mortality was 43% (104/242), and 59.6% of these deaths (62/104) were infection-related. Allogeneic HSCT recipents from unrelated donors were prone to infectious complication and higher mortality than those from matched sibling (17/39 (43.6%) vs 45/203 (22.2%), respectively; P<0.01; odd ratio 2.5; 95% confidence interval 1.2–5.1). As infection was the main post-HSCT complication in our data, more attention should be given to the management of infections in HSCT recipients.

Keywords:

HSCT, Korea, infection, fever

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