History of Infection Prior to Hematopoietic Stem Cell Transplant in the Recipient as a Risk Factor to Develop Acute Graft versus Host Disease

Abstract

Background: Acute graft-versus-host disease (aGVHD) is the most frequent and severe complication after allogeneic hematopoietic stem cell transplantation (HSCT). Objective: To determine if a history of prior infection in the allogeneic HSTC recipient is a risk factor to develop aGVHD. Methods: A retrospective cohort study based on data collected from the Department of Hematopoietic Stem Cell Transplantation at the Instituto Nacional de Pediatría (INP) from January 1998 to December 2016 was performed to identify if prior infection was a predictive risk factor for aGVHD. Results: 27 patients developed aGVHD (36.4%). Median time to aGVHD presentation was 82 days (9 to 273 days). Most patients developed grade III aGVHD. Following the multivariate analysis peripheral blood > bone marrow (OR 12.3; p < 0.001), cell dose > 8.3 × 10 6 /kg (OR 7.1; p = 0.05), peripheral blood (OR: 11.4; p < 0.001), infection 3 months prior to allogeneic transplant (OR: 4.5; p < 0.03) and CMV infection in the recipient (OR: 4.68; p < 0.03) were significant. Conclusions: Either bacterial infection or CMV infection in the recipient was significant risk factor within the aGVHD recipients; it is important to consider these factors for patients that are going to receive an allogeneic HSCT.