Profiles of infectious complications on the outcomes for the recipients of allogeneic hematopoietic stem cell transplantation.
- Author:
Ji Young RHEE
1
;
Eun Hee JANG
;
Seung Tai KIM
;
Yu Mi WI
;
Kyong Mok SON
;
Hae Suk CHEONG
;
Hyun Kyun KI
;
Won Sup OH
;
Ki Hyun KIM
;
Chul Won JUNG
;
Won Seog KIM
;
Keunchil PARK
;
Kyong Ran PECK
;
Jae Hoon SONG
Author Information
1. Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. krpeck@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
Hematopoietic stem cell transplantation;
Infections;
Mortality
- MeSH:
Aspergillus;
Bacteremia;
Bacterial Infections;
Candida;
Fever;
Fluconazole;
Fungemia;
Hematopoietic Stem Cell Transplantation*;
Hematopoietic Stem Cells*;
Humans;
Incidence;
Mortality;
Multivariate Analysis;
Neutropenia;
Nystatin;
Pneumonia;
Pseudomonas;
Risk Factors;
Stem Cells
- From:Korean Journal of Medicine
2007;72(2):200-208
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: We wanted to investigate the effect of infectious complications on the outcome of patients who received allogeneic hematopoietic stem cell transplantation (HSCT), and we determined the risk factors for predicting infectious complication and the mortality in allogeneic HSCT recipients. METHODS: We enrolled all the patients who underwent allogeneic HSCT at Samsung Medical Center from February 1996 to October 2003. RESULTS: A total of 139 patients were enrolled. A total of 450 infectious episodes were observed in 131 allogeneic recipients (90.8%). Infectious complications occurred in the allogeneic recipients [3.243.00 episodes/patient]. Microbiologically documented infection (MDI), clinically documented infection (CDI), and unknown fever (UF) accounted for 41.6%, 34.0% and 24.4%, respectively, of the total infections. Pneumonia (15.1%) was the most common infection. Among the 187 MDIs, bacterial infection, viral infection and fungal infection accounted for 50.3%, 39.6%, and 7.5%, respectively. Twelve of 24 deaths in the late post-transplantation period were related with infection. The statistically significant risk factors for infection related to mortality, by multivariate analysis, were the underlying disease risk, the duration of neutropenia, the failure of stem cell engraftment, acute GVHD, MDI, UF, the number of infectious episodes, bacteremia, fungemia, pneumonia, genitourinary tract infections, S. aureus, E. coli, Pseudomonas spp., Aspergillus spp., Non-albicans candida and CMV diseases. CONCLUSIONS: The incidence of fungal infections was still low in our institute, even though prophylaxis for fungal infections was not applied, except for gargling with nystatin. In addition, most of them were non-albican Candida and Aspergillus species. Therefore, routine fluconazole prophylaxis may not be needed in our institute.
