Microbiologically documented infections after adult allogeneic hematopoietic cell transplantation: A 5-year analysis within the Swiss Transplant Cohort study.
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State: Public
Version: Final published version
License: All rights reserved
Serval ID
serval:BIB_C8EB192EA5DF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Microbiologically documented infections after adult allogeneic hematopoietic cell transplantation: A 5-year analysis within the Swiss Transplant Cohort study.
Journal
Transplant infectious disease
Working group(s)
Swiss Transplant Cohort Study
Contributor(s)
Amico P., Aubert J.D., Banz V., Beldi G., Benden C., Berger C., Binet I., Bochud P.Y., Branca S., Bucher H., Carell T., Catana E., Geest S., Rougemont O., Dickenmann M., Duchosal M., Elkrief L., Fehr T., Ferrari-Lacraz S., Garzoni C., Soccal P.G., Gaudet C., Giostra E., Golshayan D., Hadaya K., Heim D., Hess C., Hillinger S., Hirsch H.H., Hofbauer G., Huynh-Do U., Immer F., Klaghofer R., Koller M., Laesser B., Lehmann R., Lovis C., Majno P., Manuel O., Marti H.P., Martin P.Y., Meylan P., Mohacsi P., Morel P., Mueller U., Mueller-McKenna H., Müller T., Müllhaupt B., Pascual M., Posfay-Barbe K., Rick J., Roosnek E., Rosselet A., Rothlin S., Ruschitzka F., Schaub S., Schnyder A., Seiler C., Sprachta J., Stampf S., Steiger J., Stirnimann G., Toso C., Venetz J.P., Villard J., Wick M., Wilhelm M., Yerly P.
ISSN
1399-3062 (Electronic)
ISSN-L
1398-2273
Publication state
Published
Issued date
08/2020
Peer-reviewed
Oui
Volume
22
Number
4
Pages
e13289
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Observational Study
Publication Status: ppublish
Publication Status: ppublish
Abstract
Infections are an important complication after allogeneic hematopoietic cell transplantation (allo-HCT). The present study aimed at determining the landscape of infections occurring in a large cohort of allo-HCT patients, as well as associated risk factors for infections and for one-year non-relapse mortality.
This is a retrospective cohort study using STCS and EBMT databases to assess the one-year incidence rate of infection, as well as risk factors for infections and for one-year non-relapse mortality among adult allo-HCT patients transplanted between 2010 and 2014 in Switzerland. Univariable and multivariable quasi-Poisson and multivariable Cox regression models were used.
Of 553 patients included, 486 had an infection with a global incidence rate of 3.66 infections per patient-year. Among a total of 1534 infections analyzed, viral infections were predominant (n = 1138, 74.2%), followed by bacterial (n = 343, 22.4%) and fungal (n = 53, 3.5%) infections. At one year, the cumulative incidence of relapse and non-relapse mortality was 26% and 16%, respectively. 195 (35.3%) of patients had at least one episode of severe graft-versus-host-disease (GvHD). A center effect was observed, and underlying disease, donor type, cytomegalovirus serological constellation, and GvHD were also associated with the incidence rate of infections. There was an increased risk for one-year non-relapse mortality associated with all pathogens, specifically within two months of infection, and this remained true beyond 2 months of a fungal infection.
Despite advances to limit infections in this population, they still occur in most allo-HCT patients with a major impact on survival at 1 year.
This is a retrospective cohort study using STCS and EBMT databases to assess the one-year incidence rate of infection, as well as risk factors for infections and for one-year non-relapse mortality among adult allo-HCT patients transplanted between 2010 and 2014 in Switzerland. Univariable and multivariable quasi-Poisson and multivariable Cox regression models were used.
Of 553 patients included, 486 had an infection with a global incidence rate of 3.66 infections per patient-year. Among a total of 1534 infections analyzed, viral infections were predominant (n = 1138, 74.2%), followed by bacterial (n = 343, 22.4%) and fungal (n = 53, 3.5%) infections. At one year, the cumulative incidence of relapse and non-relapse mortality was 26% and 16%, respectively. 195 (35.3%) of patients had at least one episode of severe graft-versus-host-disease (GvHD). A center effect was observed, and underlying disease, donor type, cytomegalovirus serological constellation, and GvHD were also associated with the incidence rate of infections. There was an increased risk for one-year non-relapse mortality associated with all pathogens, specifically within two months of infection, and this remained true beyond 2 months of a fungal infection.
Despite advances to limit infections in this population, they still occur in most allo-HCT patients with a major impact on survival at 1 year.
Keywords
Adolescent, Adult, Aged, Bacterial Infections/epidemiology, Databases, Factual, Female, Hematopoietic Stem Cell Transplantation/adverse effects, Hematopoietic Stem Cell Transplantation/mortality, Humans, Male, Middle Aged, Mycoses/epidemiology, Proportional Hazards Models, Recurrence, Retrospective Studies, Risk Factors, Switzerland, Time Factors, Transplantation, Homologous/adverse effects, Transplantation, Homologous/mortality, Virus Diseases/epidemiology, Young Adult, allogeneic cell transplantation, infection, mortality
Pubmed
Web of science
Create date
26/01/2024 13:55
Last modification date
10/08/2024 6:30
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