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- Title
Infectious complications following allogeneic stem cell transplantation by using anti-thymocyte globulin-based myeloablative conditioning regimens in children with hemoglobinopathies.
- Authors
Goussetis, E.; Efstathiou, E.; Paisiou, A.; Avgerinou, G.; Zisaki, K.; Giamouris, V.J.; Peristeri, I.; Kitra, V.; Vessalas, G.; Gamaletsou, M.N.; Sipsas, N.V.; Graphakos, S.
- Abstract
Background Anti-thymocyte globulin ( ATG) has been used to prevent graft failure/rejection in the setting of allogeneic stem cell transplantation (allo- SCT) for hemoglobinopathies; however, epidemiology data for transplant-related infections in this population are scarce. Method We retrospectively analyzed the epidemiology of bacterial, fungal, viral, and parasitic infections in a cohort of 105 children and adolescents with β-thalassemia ( n = 100) or sickle cell disease ( n = 5) who underwent allo- SCT using human leukocyte antigen ( HLA)-identical sibling ( n = 96) or HLA-compatible unrelated donors ( n = 9) in a single institution. All patients received an ATG-based conditioning regimen. Results The cumulative incidence of cytomegalovirus ( CMV) viremia was 45.7% (95% confidence interval [ CI] 33-55%), developing at a median of 48 (range 12-142) days without evidence of overt CMV disease. Herpes zoster developed in 8 patients at a median of 12 months post transplant, while 10 patients presented with late onset hemorrhagic cystitis at a median of 35 days post transplant. The cumulative incidence of bacteremia was 17.1% (95% CI 10.6-25%), occurring at a median of 74 (range 24-110) days. No patient developed probable or definite invasive fungal infection. Four deaths were recorded; 2 of them were attributed to infections (toxoplasmosis and Pneumocystis jirovecii pneumonia, respectively). Conclusion The rate of infections after allo- SCT, using an ATG-containing preparative regimen, in our population of pediatric patients with hemoglobinopathies is comparable to that reported elsewhere with the use of non- ATG containing regimens.
- Subjects
STEM cell transplantation; HEMOGLOBINOPATHY in children; GRAFT versus host disease; COMPLICATIONS from organ transplantation; INFECTION; CHILDREN'S health
- Publication
Transplant Infectious Disease, 2015, Vol 17, Issue 2, p201
- ISSN
1398-2273
- Publication type
Article
- DOI
10.1111/tid.12358