Frequency of Infectious Agents after Bone Marrow Transplantation in Various Regions of Iran (2001 - 2017): A Systematic Review

Context: Infections are a major cause of disease and mortality in transplant recipients. Despite the studies conducted in Iran, no comprehensive and general research is available in this area. The present study aimed to determine the frequency of infectious agents in patients after bone marrow transplantation in Iran. Method: In this systematic review, relevant studies were selected based on type and objective, and data were collected from the articles published in Iran regarding the frequency of infectious agents after bone marrow transplantation in different regions of Iran. The studies were collected using systematic search methods. Results: In total, 11 studies were identified regarding infectious agents after bone marrow transplantation. Six studies were conducted in Tehran, three studies were performed in Shiraz, and Mashhad and Semnan provinces were the locations of two separate studies. Most of the case studies identified viral agents (54.5%; n = 6), followed by fungal infectious agents (27.3%; n = 3) and bacterial agents (18.2%; n = 2). Gram-positive bacteria (bacterial agents), cytomegalovirus (viral agents), and Candida and Aspergillus (fungi) had the highest frequency after bone marrow transplantation. Conclusions: According to the results, viral, fungal, and bacterial infectious agents were respectively most frequent in patients receiving bone marrow transplants. Gram-positive bacteria (bacterial agents), cytomegalovirus (viral agents), and Candida and Aspergillus (fungi) had the highest frequency after bone marrow transplantation.

Conditioning Intensity and Probability of Live Birth after Blood or Marrow Transplantation (BMT): a BMTSS Report

We examine the impact of conditioning intensity (low intensity: non-myeloablative/reduced intensity vs. high intensity: myeloablative) and total body irradiation (TBI) on the probability of live birth after blood or marrow transplantation (BMT). Study participants were drawn from the BMT Survivor Study (BMTSS), and included 1,607 survivors transplanted 1974-2014 at age ≤45, with survival ≥2y post-BMT and age at study ≥18. Closest-age, same-sex biologic siblings (n=172) were 1:1 matched with 172 survivors. Survivors and siblings self-reported information on sociodemographic, chronic health conditions, and pregnancies. Within survivor analysis: The association between the primary exposure variable (No TBI/low-intensity conditioning; 200-800cGy TBI/low-intensity conditioning; No TBI/ high-intensity conditioning; >800cGy TBI/ high-intensity conditioning) and the odds of no post-BMT live birth was examined using multivariable logistic regression, adjusting for clinical and demographic variables. Median age at BMT was 31y (IQR=0-45), and median length of follow-up was 14.3y (IQR=2.4-41.4); 39.3% were autologous BMT recipients and 46.6% were female. Overall, 120 (8.7%) survivors reported post-BMT live births. Receipt of >800cGy TBI/ high-intensity conditioning (OR=3.7, 95%CI=1.9-7.0; ref: no TBI/low-intensity conditioning) was associated with higher odds of reporting no live birth post-BMT. In contrast, 200-800cGy TBI/low-intensity conditioning (OR=1.3, 95%CI=0.5-3.3), and no TBI/high-intensity conditioning (OR=0.9, 95%CI=0.5-1.7) were at similar risk of reporting post-BMT live birth as no TBI/low-intensity conditioning. Comparison with biologic siblings: Using conditional logistic regression, we found that BMT survivors were more likely to report no live birth (OR=2.0, 95%CI: 1.2-3.3) compared with siblings. These findings could inform conditioning intensity options for patients wishing to preserve fertility post-BMT.

To the 30th anniversary of the first children’s department of bone marrow transplantation in Russia

The article is devoted to the history of the creation of the bone marrow transplantation department and the development of pediatric oncology in the Russian Federation.