Late‐occurring infections in a contemporary cohort of hematopoietic cell transplantation survivors

Sy, Andrew; Chanson, Dayana; Teh, Jennifer Berano; Wong, F. Lennie; Nakamura, Ryotaro; Dadwal, Sanjeet; Armenian, Saro H.

doi:10.1002/cam4.3896

Cited by 7 publications

(5 citation statements)

References 42 publications

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“…A history of infectious diseases is a well-known risk factor for additional infectious diseases after allo-HCT. 23 Thus, our study suggests that ScIgRT can reduce the risk of such diseases after allo-HCT.…”

Section: Discussionmentioning

confidence: 61%

“…Thus, although we did not have a strict protocol that defined when ScIgRT should be administered, the onset of infectious diseases could be an appropriate indication. A history of infectious diseases is a well‐known risk factor for additional infectious diseases after allo‐HCT 23 . Thus, our study suggests that ScIgRT can reduce the risk of such diseases after allo‐HCT.…”

Section: Discussionmentioning

confidence: 64%

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A single‐institution pre–post comparison of subcutaneous immunoglobulin replacement therapy in allogeneic haematopoietic cell transplantation recipients

Suga,

Fuji,

Tada

et al. 2023

Br J Haematol

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SummaryImmunoglobulin replacement therapy (IgRT) reduces the risk of infection in hypogammaglobulinaemia secondary to chronic lymphocytic leukaemia and multiple myeloma. However, the benefit of IgRT, especially subcutaneous IgRT (ScIgRT), has not been assessed in hypogammaglobulinaemia after allogeneic haematopoietic cell transplantation (allo‐HCT). We performed a pre–post comparison of the clinical impact of ScIgRT after allo‐HCT in a retrospective analysis of 209 patients who underwent allogeneic HCT at our institution from 2011 to 2019. Since ScIgRT became available at our institution in April 2017, we categorized patients treated from January 2011 to March 2017 as the Pre‐ScIgRT group (n = 118) and those treated from April 2017 to December 2019 as the Post‐ScIgRT group (n = 91). The 2‐year overall survival rate was 65% in the Pre‐ScIgRT group and 81% in the Post‐ScIgRT group (p = 0.02). The cumulative incidence (CI) of non‐relapse mortality at 2 years was 18% and 7% (p = 0.02). There were 78 infectious events in 44 patients in the Pre‐ScIgRT group and 28 such events in 19 patients in the Post‐ScIgRT group. The CI of the documented infection during the observation period was between 38% and 21% (p = 0.01). Our study suggests that ScIgRT may reduce infection rates and improve prognosis after allo‐HCT.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 64%

A single‐institution pre–post comparison of subcutaneous immunoglobulin replacement therapy in allogeneic haematopoietic cell transplantation recipients

Suga,

Fuji,

Tada

et al. 2023

Br J Haematol

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“…However, the SHR was higher for leukaemia than for lymphoma survivors. This is likely the result of intensive treatments with immunosuppressive agents more commonly used in leukemias than in other hematological disorders, for which targeted and precision therapies have been available for many years (32)(33)(34)(35)(36). Unfortunately, we lack data on treatment details to support and discuss our hypothesis in detail.…”

Section: Discussionmentioning

confidence: 89%

Late Mortality, Subsequent Malignant Neoplasms and Hospitalisations in Long-Term Survivors of Adolescent and Young Adult Hematological Cancers

et al. 2022

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BackgroundIncreased success in the treatment of hematological cancers contributed to the increase of 5-year survival for most adolescent and young adults (AYAs) with these tumours. However, as 5-year survival increased, it became clear that AYA long-term survivors were at increased risk for severe late effects. Moreover, limited information on long-term cancer impact is available for AYAs, since most studies focused on children and adolescents. We aimed to assess various long-term outcomes on AYA survivors of hematological cancers.MethodsWe selected patients diagnosed with a first primary hematological cancer between 1997 and 2006, in the Italian nationwide population-based cohort of AYA cancer survivors (i.e. alive at least 5 years after cancer diagnosis). Long-term outcomes of interest were: second malignant neoplasms (SMNs), hospitalizations and overall mortality. We calculated standardized incidence ratios (SIRs), standardized hospitalization rate ratios (SHRs) and standardized mortality rate ratios (SMRs). To study morbidity patterns over time, we modeled observed incidence rates by fitting flexible parametric models for nonlinear patterns and we used linear regression for linear patterns.ResultsThe study cohort included 5,042 AYA hematological cancer survivors of which 1,237 and 3,805 had a leukaemia and lymphoma diagnosis, respectively. AYA survivors were at substantially increased risk for SMN (SIR=2.1; 95%CI=1.7; 2.6), hospitalisation (SHR=1.5; 95%CI=1.5; 1.6), and mortality (SMR=1.4; 95%CI=1.2; 1.6) with differences between leukaemia and lymphoma survivors. The highest excess risks of hospitalisations were for infectious diseases, respiratory diseases, and diseases of blood and blood-forming organs. The morbidity pattern differs over time by morbidity type.ConclusionsOur results support the need for strict follow-up plans for survivors, and call for further study to better personalised follow-up plans for AYA cancer survivors.

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“… 1 Disseminated histoplasmosis is rarely encountered in nonendemic areas, especially in patients who have previously undergone autologous bone marrow transplant. 2 This case highlights the importance of maintaining disseminated histoplasmosis in the differential in patients who have previously undergone autologous bone marrow transplant and have features consistent with invasive fungal disease.…”

Section: Introductionmentioning

confidence: 84%

Acute Colonic Perforation with Septic Shock Secondary to Disseminated Histoplasmosis in an Autologous Bone Marrow Transplant Recipient

Bhatti,

Batbileg,

et al. 2023

IDR

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Histoplasma capsulatum is an opportunistic pathogen which can lead to a wide variety of clinical presentations in the immunocompromised host. Post-transplant histoplasmosis in hematopoietic cell transplant recipients is exceedingly rare, with an incidence of <1%. We present a case of acute caecal perforation resulting from disseminated histoplasmosis in a patient who had undergone autologous bone marrow transplant for plasma cell dyscrasia. This is a 71-year-old patient who initially presented due to progressive weakness associated with shortness of breath.

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Late‐occurring infections in a contemporary cohort of hematopoietic cell transplantation survivors

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 7 publications

References 42 publications

A single‐institution pre–post comparison of subcutaneous immunoglobulin replacement therapy in allogeneic haematopoietic cell transplantation recipients

A single‐institution pre–post comparison of subcutaneous immunoglobulin replacement therapy in allogeneic haematopoietic cell transplantation recipients

Late Mortality, Subsequent Malignant Neoplasms and Hospitalisations in Long-Term Survivors of Adolescent and Young Adult Hematological Cancers

Acute Colonic Perforation with Septic Shock Secondary to Disseminated Histoplasmosis in an Autologous Bone Marrow Transplant Recipient

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