Infectious complications following allogeneic stem cell transplantation: reduced‐intensity vs. myeloablative conditioning regimens. Issue 1 (24th September 2012)

• Record Type: Journal Article
• Authors: Kim, S.‐H.; Kee, S.Y.; Lee, D.‐G.; Choi, S.‐M.; Park, S.H.; Kwon, J.‐C.; Eom, K.‐S.; Kim, Y.‐J.; Kim, H.‐J.; Lee, S.; Min, C.‐K.; Kim, D.‐W.; Choi, J.‐H.; Yoo, J.‐H.; Lee, J.‐W.; Min, W.‐S.
• Is Part Of: Transplant infectious disease. Volume 15:Issue 1(2013)
• Page Start: 49
• Page End: 59
• Publication Date: 2012-09-24
• Subjects: Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.12003
• Languages: English
• ISSNs: 1398-2273

Abstract

<abstract abstract-type="main" id="tid12003-abs-0001"> <title>Abstract</title> <sec id="tid12003-sec-0001" sec-type="section"> <title>Background</title> <p>In allogeneic stem cell transplantation (allo‐SCT), reduced‐intensity conditioning (RIC) is known for producing less regimen‐related toxicity. However, whether or not RIC reduces the risk for infection and infection‐related mortality (IRM) remains controversial.</p> </sec> <sec id="tid12003-sec-0002" sec-type="section"> <title>Methods</title> <p>We retrospectively analyzed infectious episodes and IRMs after allo‐SCTs by time period and by the intensity of the conditioning regimen (RIC [<italic>n </italic>=<italic> </italic>81] vs. myeloablative conditioning, MAC [<italic>n </italic>=<italic> </italic>150]).</p> </sec> <sec id="tid12003-sec-0003" sec-type="section"> <title>Results</title> <p>The cumulative incidence of any kind of infection was lower in the RIC group through the entire period (72% vs. 87%; <italic>P </italic>=<italic> </italic>0.007). The onset of infections was deferred in the RIC group as compared with the MAC group (<italic>P </italic>=<italic> </italic>0.012). Bacteremia occurred less frequently in the RIC group through the entire period (5% vs. 14%; <italic>P </italic>=<italic> </italic>0.044). However, the incidences of cytomegalovirus reactivation and disease, herpes zoster, virus‐associated hemorrhagic cystitis, and invasive fungal infection were not different between the two groups. Furthermore, there was no difference in relapse‐free survival and IRM between the two conditioning regimens.</p> </sec> <sec id="tid12003-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Careful monitoring and appropriate preventive/therapeutic strategies for infectious complications, comparable to those for allo‐SCT recipients with MAC, should also be applied to those with RIC, especially after engraftment.</p> </sec> </abstract>