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Autografting

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

Bone Marrow Transplantation volume 37, pages 411–418 (2006)Cite this article

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.

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Acknowledgements

Frédéric Baron is Research Associate and Yves Beguin Research Director of the National Fund for Scientific Research (FNRS, Belgium). This work was supported by grants from ‘La Fondation Frédéricq,’ ‘L’Association sportive contre le Cancer,’ ‘Le Fonds de Recherche Scientifique du CHU Sart-Tilman’ and the National Fund for Scientific Research (FNRS, Belgium). We are grateful to the medical nursing and clinical staffs for their dedicated care of the patients. We also thank Laurence Seidel and Adelin Albert from the Department of Medical Statistics for their valuable help in statistical analyses.

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  1. Department of Medicine, Division of Haematology, University of Liège, Liège, Belgium

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

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  1. P Frère
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  2. F Baron
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Correspondence to Y Beguin.

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Frère, P., Baron, F., Bonnet, C. et al. Infections after allogeneic hematopoietic stem cell transplantation with a nonmyeloablative conditioning regimen. Bone Marrow Transplant 37, 411–418 (2006). https://doi.org/10.1038/sj.bmt.1705255

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