Incidence, Risk Factors, and Outcomes of Patients Who Develop Mucosal Barrier Injury–Laboratory Confirmed Bloodstream Infections in the First 100 Days After Allogeneic Hematopoietic Stem Cell Transplant

Dandoy, Christopher E.; Kim, Soyoung; Chen, Min; Ahn, Kwang Woo; Ardura, Monica I.; Brown, Valerie I.; Chhabra, Saurabh; Díaz, Miguel Ángel; Dvorak, Christopher C.; Farhadfar, Nosha; Flagg, Aron; Ganguly, S.; Hale, Gregory A.; Hashmi, Shahrukh K.; Hematti, Peiman; Martino, Rodrigo; Nishihori, Taiga; Nusrat, Roomi; Olsson, Richard F.; Rotz, Seth J.; Sung, Anthony D.; Perales, Miguel Angel; Lindemans, Caroline A.; Komanduri, Krishna V.; Riches, Marcie L.

doi:10.1001/jamanetworkopen.2019.18668

Cited by 49 publications

(41 citation statements)

References 38 publications

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“…In terms of bacterial infections, one of the main findings of this study was the similar incidence of PE-BSIs among the different stem cell donors (45% in haploSCT and 40.5% in the non-haploSCT cohorts, p = 0.7), rates which are comparable to those reported using different GvHD prophylaxis strategies and conditioning regimen intensities [33][34][35][36][37].…”

Section: Discussionsupporting

confidence: 77%

Patterns of infection and infectious-related mortality in patients receiving post-transplant high dose cyclophosphamide as graft-versus-host-disease prophylaxis: impact of HLA donor matching

García‐Cadenas

Esquirol

Bosch‐Vilaseca

et al. 2020

Bone Marrow Transplant

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Post-transplant cyclophosphamide (PTCy) has become a promising option after allo-SCT, but infections may be more common than in traditional protocols. We herein report 117 consecutive adults who received PTCy-based alloSCT in our hospital: HaploSCT (34%), MRD (19%), and VUD (47%), respectively. The 18-month incidence of severe bacterial, viral, and IFI was 56%, 69%, and 8.7%, without differences between donor type, except for CMV infection and viral hemorrhagic cystitis, which had a higher incidence in the haploSCT cohort (58% vs. 43% and 30% vs. 8% on day +90, p < 0.05). Late infections by conventional respiratory viruses were common in all groups [33/87 (38%)]. The 2-year survival was 72% and did not differ by donor type. IRM at day 30, day 100, and 18 months was 1.7%, 4.4%, and 12%, without differences by donor type (p = 0.7). The primary cause of IRM was bacterial infection (42%). Grade 2-4 acute GvHD was the only independent predictor of IRM. Donor type had no impact on IRM or on survival. In our study, severe infections were common in all donor types using PTCy, with higher rates of early post-engraftment CMV-I and viral HC in haploSCT recipients, although lethal infections were uncommon and similar in all donor types.

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Section: Discussionsupporting

confidence: 77%

Patterns of infection and infectious-related mortality in patients receiving post-transplant high dose cyclophosphamide as graft-versus-host-disease prophylaxis: impact of HLA donor matching

García‐Cadenas

Esquirol

Bosch‐Vilaseca

et al. 2020

Bone Marrow Transplant

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“…The emergence of more modern and less toxic methods of treatments replaces HSC transplantation in hematologic malignancies. Recent reports suggest that risks of bloodstream infections caused by Gram-negative bacteria are associated with allogeneic hematopoietic transplantation[ 111 , 112 ]. Hemorrhagic cystitis is another complication that has been reported in patients post-HSC transplantation[ 113 ].…”

Section: Current Trends In the Therapeutic Use Of Stem Cellsmentioning

confidence: 99%

Recent trends in stem cell-based therapies and applications of artificial intelligence in regenerative medicine

Mukherjee

Yadav

Rajnish

2021

WJSC

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Stem cells are undifferentiated cells that can self-renew and differentiate into diverse types of mature and functional cells while maintaining their original identity. This profound potential of stem cells has been thoroughly investigated for its significance in regenerative medicine and has laid the foundation for cell-based therapies. Regenerative medicine is rapidly progressing in healthcare with the prospect of repair and restoration of specific organs or tissue injuries or chronic disease conditions where the body’s regenerative process is not sufficient to heal. In this review, the recent advances in stem cell-based therapies in regenerative medicine are discussed, emphasizing mesenchymal stem cell-based therapies as these cells have been extensively studied for clinical use. Recent applications of artificial intelligence algorithms in stem cell-based therapies, their limitation, and future prospects are highlighted.

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“…[39][40][41] Bloodstream infections during periods of neutropenia arise primarily from a gastrointestinal source. 19,37,42 Translocation of intestinal microbes is preceded by a transformation in the gastrointestinal microbiome, in which pathogenic colonization resistance and commensal organisms are lost, leading to overgrowth by a single species (domination) as well as mucosal barrier injury. 19 During HCT, the diversity and stability of the intestinal flora are disrupted, resulting in domination by bacteria associated with subsequent bacteremia.…”

Section: Microbiome Changes In Response To Cancer Therapymentioning

confidence: 99%

“…In addition, HCT is associated with the loss of host microbiome diversity, which is believed to occur as a result of chemotherapy and radiotherapy, 31 the use of empiric antibiotics, and infections, 38 as well as diet and nutritional changes 39‐41 . Bloodstream infections during periods of neutropenia arise primarily from a gastrointestinal source 19,37,42 . Translocation of intestinal microbes is preceded by a transformation in the gastrointestinal microbiome, in which pathogenic colonization resistance and commensal organisms are lost, leading to overgrowth by a single species (domination) as well as mucosal barrier injury 19 .…”

Section: Introductionmentioning

confidence: 99%

The microbiome in pediatric oncology

Rotz

Dandoy

2020

Cancer

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The human microbiome comprises a diverse set of microorganisms, which play a mostly cooperative role in processes such as metabolism and host defense. Next-generation genomic sequencing of bacterial nucleic acids now can contribute a much broader understanding of the diverse organisms composing the microbiome. Emerging evidence has suggested several roles of the microbiome in pediatric hematology/oncology, including susceptibility to infectious diseases, immune response to neoplasia, and contributions to the tumor microenvironment as well as changes to the microbiome from chemotherapy and antibiotics with unclear consequences. In this review, the authors have examined the evidence of the role of the microbiome in pediatric hematology/oncology, discussed how the microbiome may be modulated, and suggested key questions in need of further exploration.

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Incidence, Risk Factors, and Outcomes of Patients Who Develop Mucosal Barrier Injury–Laboratory Confirmed Bloodstream Infections in the First 100 Days After Allogeneic Hematopoietic Stem Cell Transplant

Cited by 49 publications

References 38 publications

Patterns of infection and infectious-related mortality in patients receiving post-transplant high dose cyclophosphamide as graft-versus-host-disease prophylaxis: impact of HLA donor matching

Patterns of infection and infectious-related mortality in patients receiving post-transplant high dose cyclophosphamide as graft-versus-host-disease prophylaxis: impact of HLA donor matching

Recent trends in stem cell-based therapies and applications of artificial intelligence in regenerative medicine

The microbiome in pediatric oncology

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