title: Infectious complications in chronic graft-versus-host disease: a retrospective study of 145 recipients of allogeneic hematopoietic stem cell transplantation with reduced- and conventional-intensity conditioning regimens.
abstract: To assess infectious complications associated with chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (HSCT) with reduced- and conventional-intensity conditioning regimens (RIC, n=91; CIC, n=54, respectively), we retrospectively analyzed data from 145 consecutive patients with cGVHD after allogeneic HSCT from a human leukocyte antigen-matched related or unrelated donor. In the present retrospective analysis, 57% (83/145) of patients with cGVHD developed infections, with a mortality rate of 27% (22/83). The incidences of bacteremia (n=28), central venous catheter-related infections (n=11), bacterial pneumonia (n=4), invasive aspergillosis (n=7), and adenoviral hemorrhagic cystitis (n=8) were significantly higher in patients with prednisolone dose >or=1 mg/kg at the time of diagnosis of cGVHD. The present results suggest that infections associated with cGVHD, especially after high-dose prednisolone, are predictive of poor outcome regardless of whether the patient received RIC or CIC.
authors.affiliation: Division of Hematology/Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yamasaki
authors.forename: Y
authors.initials: Y
authors.lastname: Heike
authors.forename: S
authors.initials: S
authors.lastname: Mori
authors.forename: T
authors.initials: T
authors.lastname: Fukuda
authors.forename: D
authors.initials: D
authors.lastname: Maruyama
authors.forename: R
authors.initials: R
authors.lastname: Kato
authors.forename: E
authors.initials: E
authors.lastname: Usui
authors.forename: K
authors.initials: K
authors.lastname: Koido
authors.forename: S
authors.initials: S
authors.lastname: Kim
authors.forename: R
authors.initials: R
authors.lastname: Tanosaki
authors.forename: K
authors.initials: K
authors.lastname: Tobinai
authors.forename: T
authors.initials: T
authors.lastname: Teshima
authors.forename: Y
authors.initials: Y
authors.lastname: Takaue
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001228:Aspergillosis / Q000453:epidemiology / Q000382:microbiology; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D002066:Busulfan / Q000008:administration & dosage; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002908:Chronic Disease; D003141:Communicable Diseases / Q000150:complications / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000453:epidemiology / Q000382:microbiology; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous / Q000009:adverse effects*; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives; D014916:Whole-Body Irradiation
chemical_list: D003520:Cyclophosphamide; D014740:Vidarabine; D002066:Busulfan; C024352:fludarabine