BACKGROUND: In allogeneic stem cell transplantation (allo-SCT), reduced-intensity conditioning (RIC) is known for producing less regimen-related toxicity. However, whether or not RIC reduces the risk for infection and infection-related mortality (IRM) remains controversial. METHODS: We retrospectively analyzed infectious episodes and IRMs after allo-SCTs by time period and by the intensity of the conditioning regimen (RIC [n = 81] vs. myeloablative conditioning, MAC [n = 150]). RESULTS: The cumulative incidence of any kind of infection was lower in the RIC group through the entire period (72% vs. 87%; P = 0.007). The onset of infections was deferred in the RIC group as compared with the MAC group (P = 0.012). Bacteremia occurred less frequently in the RIC group through the entire period (5% vs. 14%; P = 0.044). However, the incidences of cytomegalovirus reactivation and disease, herpes zoster, virus-associated hemorrhagic cystitis, and invasive fungal infection were not different between the two groups. Furthermore, there was no difference in relapse-free survival and IRM between the two conditioning regimens. CONCLUSION: Careful monitoring and appropriate preventive/therapeutic strategies for infectious complications, comparable to those for allo-SCT recipients with MAC, should also be applied to those with RIC, especially after engraftment.
BACKGROUND: In allogeneic stem cell transplantation (allo-SCT), reduced-intensity conditioning (RIC) is known for producing less regimen-related toxicity. However, whether or not RIC reduces the risk for infection and infection-related mortality (IRM) remains controversial. METHODS: We retrospectively analyzed infectious episodes and IRMs after allo-SCTs by time period and by the intensity of the conditioning regimen (RIC [n = 81] vs. myeloablative conditioning, MAC [n = 150]). RESULTS: The cumulative incidence of any kind of infection was lower in the RIC group through the entire period (72% vs. 87%; P = 0.007). The onset of infections was deferred in the RIC group as compared with the MAC group (P = 0.012). Bacteremia occurred less frequently in the RIC group through the entire period (5% vs. 14%; P = 0.044). However, the incidences of cytomegalovirus reactivation and disease, herpes zoster, virus-associated hemorrhagic cystitis, and invasive fungal infection were not different between the two groups. Furthermore, there was no difference in relapse-free survival and IRM between the two conditioning regimens. CONCLUSION: Careful monitoring and appropriate preventive/therapeutic strategies for infectious complications, comparable to those for allo-SCT recipients with MAC, should also be applied to those with RIC, especially after engraftment.
Authors: Lidiane Miotto Barretta; Lúcia Marinilza Beccaria; Cláudia Bernardi Cesarino; Maria Helena Pinto Journal: Rev Lat Am Enfermagem Date: 2016-06-07
Authors: R Parody; R Martino; R de la Cámara; A García-Noblejas; A Esquirol; I Garcia-Cadenas; T Villaescusa; D Caballero; M Rovira; F Fernandez-Avilés; F J Marquez-Malaver; I Espigado; C Castilla-Llorente; I Heras; M A Cabero; J R Cabrera; P Barba; D Valcarcel; I Sánchez-Ortega; R F Duarte; D Serrano; F Carretero; L Vazquez Journal: Bone Marrow Transplant Date: 2014-10-27 Impact factor: 5.483
Authors: Celalettin Ustun; Soyoung Kim; Min Chen; Amer M Beitinjaneh; Valerie I Brown; Parastoo B Dahi; Andrew Daly; Miguel Angel Diaz; Cesar O Freytes; Siddhartha Ganguly; Shahrukh Hashmi; Gerhard C Hildebrandt; Hillard M Lazarus; Taiga Nishihori; Richard F Olsson; Kristin M Page; Genovefa Papanicolaou; Ayman Saad; Sachiko Seo; Basem M William; John R Wingard; Baldeep Wirk; Jean A Yared; Miguel-Angel Perales; Jeffery J Auletta; Krishna V Komanduri; Caroline A Lindemans; Marcie L Riches Journal: Blood Adv Date: 2019-09-10