Pre-Engraftment Bloodstream Infections after Allogeneic Hematopoietic Cell Transplantation: Impact of T Cell-Replete Transplantation from a Haploidentical Donor

摘要

Highlights " Pre-engraftment bloodstream infections (BSIs) affected 30% of allogenic hematopoietic stem cell transplantation recipients. " The risk was greatest in cases of T cell-replete haploidentical transplants. " Gram-negative BSI, particularly if carbapenem-resistant, had a negative impact on survival. Abstract Bloodstream infections (BSIs) are frequent and important infectious complications after hematopoietic cell transplantation (HCT). The aim of this study was to analyze the incidence, risk factors, and outcome of pre-engraftment BSIs after allogeneic HCT. We retrospectively analyzed data from 553 consecutive patients who underwent HCT between 2010 and 2016. Sixty percent of the patients received T cell-replete unmanipulated haploidentical bone marrow with high-dose post-transplantation cyclophosphamide. The BSI rate was 30%; among isolated 213 pathogens, 54% were Gram-positive, 43% were Gram-negative, and 3% were fungi. Independent risk factors for pre-engraftment BSI were transplantation from a haploidentical donor or from cord blood ( P P = .002), age ( P = .04), and myeloproliferative disorders or aplastic anemia ( P P P = .045), year of HCT ( P = .027), nonengraftment ( P = .001), and pre-engraftment BSI ( P