Incidence and Risk Factors of Early Bacterial Infections after Unrelated Cord Blood Transplantation |
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| Affiliation: | 1. Department of Pediatrics, Nagoya City East Medical Center, Nagoya, Japan;2. Department of HSCT Data Management, Nagoya University School of Medicine, Nagoya, Japan;3. Division of Hematology/Oncology, Children''s Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan;4. Department of Cell Transplantation & Regenerative Medicine, Tokai University School of Medicine, Isehara, Japan;5. Department of Hematology, Toranomon Hospital, Tokyo, Japan;6. Division of Molecular Therapy, The Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan;7. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan;8. Department of Transfusion Medicine, Tokyo Metropolitan Fuchu Hospital, Fuchu, Japan;9. Division of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan;10. Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan;11. Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan;12. Division of Cell Processing and Transfusion, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan;13. Hokkaido Red Cross Blood Center, Sapporo, Japan;14. Blood Preparation Department, The Japanese Red Cross Tokyo Blood Center, Tokyo, Japan;15. Department of Blood Transfusion, Hyogo College of Medicine, Nishinomiya, Japan;16. Department of Obstetrics/Gynecology, Maternal and Child Health Center Aiiku Hospital, Tokyo, Japan;17. Nagoya Central Hospital, Nagoya, Japan |
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| Abstract: | Incidence and characteristics of early bacterial infection within 100 days after unrelated cord blood transplantation (UCBT) were assessed for 664 pediatric and 1208 adult recipients in Japan. Cumulative incidence of early bacterial infection at day 100 post-UCBT was 11% (95% confidence interval [CI], 8%-13%) for children and 21% (CI, 19%-24%) for adults (P < .0001). Early bacterial infection in adults had a significant impact on mortality (hazard ratio [HR] = 2.1, CI, 1.7-2.6; P < .0001), although no significant risk factors were identified. Multivariate analysis identified older age group (6-10, and 11-15 years versus 0-5 years of age) at transplant (HR = 2.0 and 2.7, CI, 1.1-3.5 and 1.4-4.9; P = .020 and .002, respectively) as an independent risk factor of early bacterial infection for children. Early bacterial infection in children did not have a significant impact on mortality when adjusted. Of 315 bacteremia, 74% were caused by Gram-positive microorganisms. Pneumonia occurred in 39 patients including 13 cases of Stenotrophomonas maltophilia pneumonia. Early bacterial infection had a negative effect on survival for adults and the median day of development was 10 days after transplant, suggesting that the prevention of bacterial infection in the very early post-UCBT phase is important. |
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