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Infectious complications in pediatric allogeneic hematopoietic stem cell transplantation recipients-A retrospective clinical and epidemiological cohort study.
Pinto, Tyane de Almeida; Jardim, Bruno Araújo; Breda, Giovanni Luís; Morales, Hugo Manuel Paz; Bonfim, Carmem; Raboni, Sonia Mara.
Afiliação
  • Pinto TA; Postgraduate Program in Internal Medicine and Health Science, Federal University of Paraná, Curitiba, Brazil.
  • Jardim BA; Postgraduate Program in Internal Medicine and Health Science, Federal University of Paraná, Curitiba, Brazil.
  • Breda GL; Infectious Diseases Division, Federal University of Paraná, Curitiba, Brazil.
  • Morales HMP; Infectious Diseases Division, Federal University of Paraná, Curitiba, Brazil.
  • Bonfim C; Bone Marrow Transplant Division, Federal University of Paraná, Curitiba, Brazil.
  • Raboni SM; Postgraduate Program in Internal Medicine and Health Science, Federal University of Paraná, Curitiba, Brazil.
Transpl Infect Dis ; 22(5): e13369, 2020 Oct.
Article em En | MEDLINE | ID: mdl-32538520
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is an important therapeutic strategy for several hematologic diseases. In the absence of a matched related donor, allogeneic HSCT has been associated with increased risk of infectious complications. Here, we present the clinical and epidemiological characteristics of early infectious complications in children undergoing HSCT from Southern Brazil. METHODS: This is a retrospective unicentric cohort study of infections in all children receiving their first HSCT during the period between 2010 and 2017. RESULTS: Data from 292 patients were analyzed; bone marrow failures (52.7%) comprised most of the baseline diagnosis. Bone marrow (BM) was the stem cell source in 254 (87%), followed by cord blood (CB) in 34 (11.6%) children. The use of alternative donors (77.8%) and presence of acute graft-vs-host disease (GVHD) (23.6%) were associated with an increased risk of viral and fungal infection. Bacterial infection was observed in 79 patients (27%); 220 patients (75.3%) were diagnosed with viral infection, and 35 patients (12%) developed fungal infection. The presence of fungal disease together with the presence of multiple infections during follow-up was associated with an increased risk of death (P < .001). CONCLUSIONS: The clinical profile of HSCT-related infections in this cohort suggests that prognosis in allogeneic HSCT is influenced by the source of stem cells (CB having worse prognosis), presence of acute GVHD and complications arising from fungal infections. The appropriate management of these factors has the potential to improve the overall prognosis rates in pediatric allogeneic HSCT recipients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Células-Tronco Hematopoéticas / Doença Enxerto-Hospedeiro Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: Transpl Infect Dis Assunto da revista: TRANSPLANTE Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Dinamarca
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Células-Tronco Hematopoéticas / Doença Enxerto-Hospedeiro Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: Transpl Infect Dis Assunto da revista: TRANSPLANTE Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Dinamarca