Allogeneic Hematopoietic Stem Cell Transplantation for the Treatment of Severe Aplastic Anemia Patients with Infection: A Single-Center Retrospective Study

Xu, Shan; Wu, Liangliang; Zhang, Yuping; Mo, Wenjian; Zhou, Ming; Li, Yumiao; Pan, Shiyi; Wang, Shunqing

doi:10.1016/j.bbmt.2018.07.018

Cited by 15 publications

(15 citation statements)

References 37 publications

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“…These results are consistent with those of a previous study reporting similar outcomes for upfront URD HSCT and MSD HSCT in pediatric SAA patients [12]. In addition, univariate and multivariate analyses identified poor performance (ECOG score 3) as an adverse factor for survival in patients who underwent HSCT, which has also been reported in several previous studies [17,50,51]. Patient age is a predictor of survival in URD HSCT [5,14,52,53].…”

Section: Discussionsupporting

confidence: 91%

“…The conditioning therapy for the MSD HSCT recipients consisted of CY (50 mg/kg/day from day -5 to day -2) plus rabbit ATG (2.5 mg/kg/day from day -5 to day -2), Flu (30 mg/m 2 /day from day -7 to day -4) plus CY (40 mg/kg/day from day -7 to day -4) plus rabbit ATG (2.5 mg/kg/day from day -5 to day -2), or BU (.8 mg/kg/day from day -7 to day -6) plus CY (40 mg/kg/day from day -5 to day -2) plus rabbit ATG (2.5 mg/kg/day from day -5 to day -2). The transplantation procedure, including HLA typing, stem cell harvesting, and graftversus-host disease (GVHD) prophylaxis, has been described in our previous reports [17,18]. In patients who underwent URD HSCT, mobilized peripheral blood stem cells (PBSCs) were the sole stem cell source, whereas patients who underwent MSD HSCT received both BM and PBSCs.…”

Section: Transplantation Protocols and Supportive Carementioning

confidence: 99%

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Comparable Outcomes of First-Line Hematopoietic Stem Cell Transplantation from Unrelated and Matched Sibling Donors in Adult Patients with Aplastic Anemia: A Retrospective Single-Center Study

Zhang

et al. 2019

Biology of Blood and Marrow Transplantation

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To explore the feasibility of upfront unrelated donor (URD) hematopoietic stem cell transplantation (HSCT) in the treatment of adult aplastic anemia (AA), we conducted a retrospective, single-center study and compared the outcomes of adult patients who underwent first-line URD HSCT or matched sibling donor (MSD) HSCT between August 2012 and June 2018. In all, 23 URD HSCT recipients had an increased cumulative incidence of grade II acute graft-versus-host disease (aGVHD) (21.7% versus 3.4%; P =.007), but similar rates of secondary graft failure (8.7 § 6.0% versus 6.9 § 3.4%; P = .764), chronic GVHD (cGVHD) (18.2% versus 8.8%; P = .285), extensive cGVHD (9.1% versus 3.5%; P = .328), 5-year estimated overall survival (87.0% versus 94.2%; P = .501), and 5-year estimated failurefree survival (82.0% versus 89.3%; P = .404) compared with 58 MSD HSCT recipients treated during the same period. After using propensity score matching to reduce the influence of potential confounders, the 2 groups were well balanced in terms of pretransplantation clinical factors. The median survival time was similar, and no significant differences in the aforementioned outcomes were observed between the 2 groups. Our results suggest that URD HSCT may be an effective and feasible option for first-line therapy in adult AA patients who lack an MSD.

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Section: Discussionsupporting

confidence: 91%

Section: Transplantation Protocols and Supportive Carementioning

confidence: 99%

Comparable Outcomes of First-Line Hematopoietic Stem Cell Transplantation from Unrelated and Matched Sibling Donors in Adult Patients with Aplastic Anemia: A Retrospective Single-Center Study

Zhang

et al. 2019

Biology of Blood and Marrow Transplantation

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“…Of note, in this study 5/65 patients suffered from SM infection of the lung or soft tissue and were classified as incomplete responders to anti-infective treatment. None of those patients suffered from SM bacteremia [9], the mortality rate of which is reported to be as high as 10–69% [5].…”

Section: Discussionmentioning

confidence: 99%

A Mosquito Bite with Devastating Complications in an Immunocompromised Patient

et al. 2019

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Infectious complications such as invasive aspergillosis or infection with Stenotrophomonas maltophilia (SM) in immunocompromised patients are associated with a high mortality rate. Our report concerns a 40-year-old male newly diagnosed very severe aplastic anemia (vSAA) who in consequence of a mosquito bite was suffering from skin lesion and consecutive soft tissue phlegmon subsequent to the administration of antithymocyte globulin; a full-thickness autologous meshed skin graft successfully performed to cover skin ulcera after allogeneic stem cell transplantation (SCT). This unusual case illustrates the importance of appropriate diagnosis, anti-infective therapy and close interdisciplinary diagnostic algorithms to minimalize side effects and the selection of resistant strains and to improve patients’ outcome.

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“…Successful outcome of HCT may be affected by severe complications, among them infections. Patients with BMF, undergoing alloHCT are at particular risk of having infections attributed to severe impairment of the immune system, caused by the disease and its treatment in pretransplant period and use of conditioning regimens and immunosuppressive therapy post‐transplant …”

Section: Introductionmentioning

confidence: 99%

“…Patients with BMF, undergoing al-loHCT are at particular risk of having infections attributed to severe impairment of the immune system, caused by the disease and its treatment in pretransplant period and use of conditioning regimens and immunosuppressive therapy post-transplant. [4][5][6][7][8][9][10] The objective of the study was to analyze profile of infections in a large cohort of children with BMFS following allogeneic HCT.…”

Section: Introductionmentioning

confidence: 99%

Infection profile in children and adolescents with bone marrow failures treated with allogeneic hematopoietic stem cell transplantation

Zaucha‐Prażmo

Zawitkowska

Lejman

et al. 2019

Pediatric Transplantation

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Background The objective of the study was to analyze the profile of infections in children with BMF following alloHCT. Methods Data of 169 consecutive children with inherited and acquired BMF treated with alloHCT between 2012 and 2017 in Polish pediatric transplant departments were analyzed in registry‐based retrospective study, with respect to the type of infection, and clinical outcome. Results At least 1 infection was diagnosed in 107/169 patients (60.4%). In total, 182 infections were diagnosed. The most common were VI (96; 52.7%), followed by BI (71; 39.0%), and FI (15; 8.2%), P < .001. The most common etiological factors of VI were as follows: CMV (38.5%), EBV (22.9%), and BK virus (24%); while of BI were as follows: Staphylococcus spp. (17; 23.9%), Enterococcus faecium (10; 14.1%), and Klebsiella pneumoniae (9; 12.7%). No difference was found between the occurrence of infections with respect to donor type, graft source, and conditioning type. GvHD had no impact on the incidence of VI, BI, and FI. Fifteen FI were diagnosed in 12 patients, of which 14 FI were diagnosed in children transplanted for FA. Of total 107 children, 9 died (8.4%), of which 4 (3.7%) due to infections: bacterial sepsis (2) and invasive FI (2). Conclusion Infections in children with BMF following alloHCT remain an important cause of morbidity. Children with FA had high incidence of FI. In our analysis, aGvHD had no impact on the occurrence on infections, although the study was not strong enough to prove such a difference.

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Allogeneic Hematopoietic Stem Cell Transplantation for the Treatment of Severe Aplastic Anemia Patients with Infection: A Single-Center Retrospective Study

Cited by 15 publications

References 37 publications

Comparable Outcomes of First-Line Hematopoietic Stem Cell Transplantation from Unrelated and Matched Sibling Donors in Adult Patients with Aplastic Anemia: A Retrospective Single-Center Study

Comparable Outcomes of First-Line Hematopoietic Stem Cell Transplantation from Unrelated and Matched Sibling Donors in Adult Patients with Aplastic Anemia: A Retrospective Single-Center Study

A Mosquito Bite with Devastating Complications in an Immunocompromised Patient

Infection profile in children and adolescents with bone marrow failures treated with allogeneic hematopoietic stem cell transplantation

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