Investigation of risk factors associated with erythrocyte engraftment after ABO‐incompatible hematopoietic stem cell transplantation

2021 ◽  
Author(s):  
Ryu Yanagisawa ◽  
Hideyuki Nakazawa ◽  
Sayaka Nishina ◽  
Shoji Saito ◽  
Tomonari Shigemura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem ◽  
Factors Associated

scholarly journals Retrospective Evaluation of Incidence and Prognostic Factors for Stenotrophomonas Maltophilia Bacteremia Following Allogeneic Hematopoietic Stem Cell Transplantation

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4626-4626
Author(s):  
Kaito Harada ◽  
Noritaka Sekiya ◽  
Shugo Sasaki ◽  
Satoshi Kaito ◽  
Shuhei Kurosawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Stenotrophomonas Maltophilia ◽  
Albumin Level ◽  
Hematopoietic Stem ◽  
Factors Associated

Abstract Background: Stenotrophomonas maltophilia (S. maltophilia) bacteremia in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients is associated with significant morbidity and mortality rate. Although several predisposing risk factors for S. maltophilia bacteremia following allo-HSCT have been identified, there is no agreement or consistency among clinical factors on whether to predict treatment outcome or not. Methods: From January 2005 to December 2014, data on demographic and clinical characteristics, treatment and outcome were collected for all S. maltophilia bacteremia cases observed at an 800-bed tertiary care hospital with a 32-bed transplantation ward. They were analyzed with respect to incidence and 90-day mortality. The risk factors associated with 90-day mortality of allo-HSCT recipients with S. maltophilia bacteremia were also analyzed by Log-rank test according to age, sex, neutropenia, platelet, C-reactive protein (CRP), albumin, creatinine, engraftment, graft-versus-host disease, primary disease risk, severe sepsis or septic shock, complicated infection, and conditioning intensity. Significant variables in the univariate analysis were included in the multivariate Cox proportional-hazards regression model. Results: A total of 65 patients (47 patients in allo-HSCT recipients and 18 patients in non allo-HSCT recipients) with S. maltophilia bacteremia were identified, with the incidence of 1.17 cases per 100 admissions and 0.35 cases per 1000 patient-days. The incidence was significantly high in allo-HSCT recipients compared to non allo-HSCT recipients (6.53 vs 0.36 per 100 admission, p<0.001) and was apparently increased during the last 2010 to 5 years (1.79 vs 0.63 per 100 admission, p<0.001). The 90-day mortality including all causes of death in allo-HSCT recipients and non allo-HSCT recipients were 43% and 28%, respectively. In multivariate analysis, the independent risk factors associated with 90-day mortality of allo-HSCT recipients were a high CRP level (>=10.0 mg/dl) (adjusted hazard ratio [aHR], 4.43; 95% confidence interval [CI], 1.55-12.63; p<0.001) and a low albumin level (<3.0 g/dl) (aHR, 12.67; 95%CI, 3.94-40.71; p<0.001) (Figure 1, 2, and Table). Patients with high CRP or low albumin level were likely to carry the complicated infection or the failure of the initial antimicrobial therapy (p=0.001). Among nine patients with high CRP and low albumin level, five of them had pneumonia at the onset of bacteremia and the others developed pneumonia under effective treatment in median three-days. Conclusion: The incidence of S. maltophilia bacteremia was increasing during the last 5 years and 90-day mortality was high in allo-HSCT setting compared to non allo-HSCT setting. Higher CRP value or lower albumin level as a result of more complicated infection may predict poor prognosis of patients with S. maltophilia bacteremia. Disclosures No relevant conflicts of interest to declare.

Incidence of, and Risk Factors for, Nosocomial Infections Among Hematopoietic Stem Cell Transplantation Recipients, With Impact on Procedure-Related Mortality

2001 ◽  
Vol 22 (08) ◽  
pp. 510-517 ◽  
Author(s):  
Carlo Marena ◽  
Marco Zecca ◽  
Maria Luisa Carenini ◽  
Angela Bruschi ◽  
Maria Luigia Bassi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Nosocomial Infections ◽  
Hematopoietic Stem ◽  
Factors Associated ◽  
Gvhd Prophylaxis

AbstractObjectives:To determine the incidence of, and risk factors for, nosocomial infections (NIs) occurring among hematopoietic stem cell transplantation (HSCT) recipients during hospitalization and to evaluate the impact of these NIs on patient outcome.Design:A two-year prospective observational study in two HSCT units.Patients:All patients admitted to the HSCT units between February 1997 and March 1999.Setting:A teaching hospital.Methods:After admission to the HSCT units, the patients were followed prospectively on a daily basis to collect all pertinent variables for the development of NIs.Results:49 NIs were identified in 34 of the 143 patients screened. The incidence of NIs and infected patients was 34.2% and 23.7%, respectively. The incidence density of NI was 8.96 per 1,000 patient-days. The most frequent NIs were bloodstream infections ([BSIs], 42.8%) and respiratory tract infections (28.6%). Other sites involved were as follows: eye (8.2%), urinary tract (6.1%), gastrointestinal tract (6.1%), skin (4.1%), ear (2%), and central venous catheter ([CVC], 2%). Because of the predominance and clinical relevance of BSIs, we examined both intrinsic and extrinsic risk factors associated with these infections. Independent risk factors for BSIs were allograft from matched unrelated or partially matched family donor, graft-versus-host disease (GVHD) prophylaxis without methotrexate (MTX), type of CVC, and duration of total parenteral nutrition. Four variables were independently associated with mortality occurring during hospitalization: culture-proven BSIs, advanced disease phase at transplant, type of transplant, and absence of MTX for GVHD prophylaxis.Conclusions:The study identified several factors associated with increased risk of BSIs among HSCT patients. Because BSIs are life-threatening complications for HSCT recipients, preventive measures aimed at reducing the incidence of these infections among patients given HSCT should be adopted.

P1825ANALYSIS OF LATE RENAL COMPLICATIONS AND RISK FACTORS IN CHILDREN WITH HEMATOPOIETIC STEM CELL TRANSPLANTATION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Anar Gurbanov ◽  
Bora Gülhan ◽  
Barış Kuşkonmaz ◽  
Fatma Visal Okur ◽  
Duygu Uçkan Çetinkaya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem ◽  
Renal Complications

Abstract Background and Aims The aim of the study is to investigate the incidence and risk factors of hypertension (HT) and chronic kidney disease (CKD) in patients who had hematopoietic stem cell transplantation (HSCT) during their childhood. Method Patients who had HSCT between January 2010-2019 with a minimum follow-up period of 6 months were included in the study. Data regarding renal complications were collected from the medical records of the patients. Guidelines of European Society of Hypertension (ESH) and American Academy of Pediatrics (APA) were used for the evaluation of hypertension. 24-hr ambulatory blood pressure monitoring (ABPM) was performed in children older than 5 years of age (68 patients). Ambulatory hypertension is diagnosed when systolic and/or diastolic blood pressure (BP) load is higher than 25%. Ambulatory prehypertension is diagnosed when mean systolic and/or diastolic BP is less than 95th percentile with systolic and/or diastolic BP load higher than 25%. Results A total of 72 patients (41 males and 31 females) were included in the study. The mean age of the patients at last visit was 10.8±4 years. ABPM revealed ambulatory HT in 6 patients (8.8%) and ambulatory prehypertension in 12 patients (17.6%). Office BP revealed HT in 3 patients (4.2%) and increased BP in four patients (5.6%) according to APA guideline (2017). In cohort, 12 patients with normal office BP (according to APA guideline) had ambulatory prehypertension or hypertension with ABPM. Office BP revealed HT in 1 patient (1.4%) and high-normal BP in 3 patients (4.2%) according to ESH guideline. In cohort, 15 patients with normal office BP (according to ESH guideline) had ambulatory prehypertension or hypertension with ABPM (Table 1). After a mean follow-up period of 4.4±2.5 years, CKD developed in 8 patients (11.1%). Patients with chronic graft-versus-host disease, with HLA-mismatched HSCT and/or transplantation of peripheric or cord blood hematopoietic stem cells had increased risk of CKD (p=0.041, p=0.033 and p=0.002, respectively). Conclusion Patients with HSCT should be regularly followed for the development of HT and ABPM should be used on regular basis. Patients with risk factors should be closely monitored for the development of CKD.

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