title: Increased bacterial infections after transfusion of leukoreduced non-irradiated blood products in recipients of allogeneic stem cell transplants after reduced-intensity conditioning.
abstract: Blood components transfused to hematopoietic stem cell transplant (HSCT) recipients are irradiated to prevent transfusion-associated graft-versus-host disease (TA-GVHD). The effect of transfusing non-irradiated blood products in HSCT outcome, including incidence of transplant complications, bacterial infections, acute and chronic GVHD presentation, and characteristics, has not been documented. Clinical records as well as blood bank and electronic databases of HSCT patients grafted after reduced-intensity conditioning who received irradiated versus non-irradiated blood products, after blood irradiation became unavailable at our center, were scrutinized for transplant outcome, clinical evolution, engraftment characteristics including days to neutrophil and platelet recovery, acute and chronic GVHD, rate and type of infections, and additional transplant-related comorbidities. All transfused blood products were leukoreduced. A total of 156 HSCT recipients was studied, 73 received irradiated and 83 non-irradiated blood components. Bacterial infections were significantly more frequent in patients transfused with non-irradiated blood products, P = .04. Clinically relevant increased rates of fever and neutropenia and mucositis were also documented in these patients. No cases of TA-GVHD occurred. Classical GVHD developed in 37 patients (50.7%) who received irradiated blood products and 36 (43.9%) who received non-irradiated blood products, P = .42. Acute GVHD developed in 28 patients (38.4%) in the blood-irradiated and 33 patients (39.8%) in the non-irradiation group, P = .87. The 2-year GVHD-free survival rate was 40% in the irradiated versus 40.6% in the non-irradiation group, P = .071. Increased bacterial infections were found in HSCT recipients transfused with non-irradiated blood products, which ideally must always be irradiated.
authors.affiliation: Department of Hematology, Internal Medicine Division, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México. Electronic address: carjaime@hotmail.com.
authors.forename: José C
authors.initials: JC
authors.lastname: Jaime-Pérez
authors.affiliation: Department of Hematology, Internal Medicine Division, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México.
authors.forename: César D
authors.initials: CD
authors.lastname: Villarreal-Villarreal
authors.affiliation: Department of Hematology, Internal Medicine Division, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México.
authors.forename: Rosario
authors.initials: R
authors.lastname: Salazar-Riojas
authors.affiliation: Department of Hematology, Internal Medicine Division, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México.
authors.forename: Nereida
authors.initials: N
authors.lastname: Méndez-Ramírez
authors.affiliation: Department of Hematology, Internal Medicine Division, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Vázquez-Garza
authors.affiliation: Department of Hematology, Internal Medicine Division, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México.
authors.forename: David
authors.initials: D
authors.lastname: Gómez-Almaguer
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D001424:Bacterial Infections / Q000453:epidemiology* / Q000209:etiology; D016913:Blood Component Transfusion; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000628:therapy; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D047589:Leukocyte Reduction Procedures; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019172:Transplantation Conditioning
keywords: Graft-versus-host disease (GVHD); Hematopoietic stem cell transplant; Irradiation of blood products; Leukoreduction; Reduced-intensity conditioning; TA-GVHD