Microbiologically documented infections after adult allogeneic hematopoietic cell transplantation: A 5‐year analysis within the Swiss Transplant Cohort study. Issue 4 (27th April 2020)

• Record Type: Journal Article
• Authors: Vu, Diem‐Lan; Dayer, Julie‐Anne; Masouridi‐Levrat, Stavroula; Combescure, Christophe; Boely, Elsa; Khanna, Nina; Mueller, Nicolas J.; Kleber, Martina; Medinger, Michael; Halter, JOERG; Passweg, Jakob; Müller, Antonia M.; Schanz, Urs; Chalandon, Yves; Neofytos, Dionysios; van Delden, Christian; Kaiser, Laurent
• Other Names: Amico Patrizia investigator.; Aubert John‐David investigator.; Banz Vanessa investigator.; Beldi Guido investigator.; Benden Christian investigator.; Berger Christoph investigator.; Binet Isabelle investigator.; Bochud Pierre‐Yves investigator.; Branca Sanda investigator.; Bucher Heiner investigator.; Carell Thierry investigator.; Catana Emmanuelle investigator.; Geest Sabina investigator.; Rougemont Olivier investigator.; Dickenmann Michael investigator.; Duchosal Michel investigator.; Elkrief Laure investigator.; Fehr Thomas investigator.; Ferrari‐Lacraz Sylvie investigator.; Garzoni Christian investigator.; Soccal Paola Gasche investigator.; Gaudet Christophe investigator.; Giostra Emiliano investigator.; Golshayan Déla investigator.; Hadaya Karine investigator.; Heim Dominik investigator.; Hess Christoph investigator.; Hillinger Sven investigator.; Hirsch Hans H investigator.; Hofbauer Günther investigator.; Huynh‐Do Uyen investigator.; Immer Franz investigator.; Klaghofer Richard investigator.; Koller Michael investigator.; Laesser Bettina investigator.; Lehmann Roger investigator.; Lovis Christian investigator.; Majno Pietro investigator.; Manuel Oriol investigator.; Marti Hans‐Peter investigator.; Martin Pierre Yves investigator.; Meylan Pascal investigator.; Mohacsi Paul investigator.; Morel Philippe investigator.; Mueller Ulrike investigator.; Mueller‐McKenna Helen investigator.; Müller Thomas investigator.; Müllhaupt Beat investigator.; Pascual Manuel investigator.; Posfay‐Barbe Klara investigator.; Rick Juliane investigator.; Roosnek Eddy investigator.; Rosselet Anne investigator.; Rothlin Silvia investigator.; Ruschitzka Frank investigator.; Schaub Stefan investigator.; Schnyder Aurelia investigator.; Seiler Christian investigator.; Sprachta Jan investigator.; Stampf Susanne investigator.; Steiger Jürg investigator.; Stirnimann Guido investigator.; Toso Christian investigator.; Venetz Jean‐Pierre investigator.; Villard Jean investigator.; Wick Madeleine investigator.; Wilhelm Markus investigator.; Yerly Patrick investigator.;
• Is Part Of: Transplant infectious disease. Volume 22:Issue 4(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-04-27
• Subjects: allogeneic cell transplantation -- infection -- mortality; Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.13289
• Languages: English
• ISSNs: 1398-2273

Abstract

Abstract: Background: 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. Methods: 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. Results: 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. Conclusion: 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.