title: Infections after T-replete haploidentical transplantation and high-dose cyclophosphamide as graft-versus-host disease prophylaxis.
abstract: BACKGROUND
  Recently, a platform of T-cell replete haploidentical hematopoietic stem cell transplantation (haplo-HSCT) using post-transplant cyclophosphamide (Cy) has shown high reproducibility and acceptable safety profile.
  
  
  METHODS
  This prospective cohort analysis allowed us to collect data on infections among 70 consecutive recipients of haplo-HSCT affected by various hematologic malignancies.
  
  
  RESULTS
  After a median follow-up of 23 months, cumulative incidence of viral infections was 70% (95% confidence interval [CI] 59-81) at 100 days and 77% (95% CI 67-87) at 1 year; 35 of 65 patients at risk had CMV reactivation (54%) and the rate of polyomavirus-virus-associated cystitis was 19% (13/70). Cumulative incidence of bacterial and fungal infections at 1 year were 63% (95% CI 51-75) and 12% (95% CI 4-19), respectively. Of note, only 1 invasive fungal infection occurred beyond 1 year after transplant (day +739).
  
  
  CONCLUSIONS
  In conclusion, despite a high rate of viral infections in the early period, present data suggest a satisfactory infectious profile after T-cell replete haplo-HSCT using post-transplant Cy. These results may help clinicians to improve both prophylactic and therapeutic antimicrobial strategies in this emerging haploidentical setting.
authors: Department of Oncology and Hematology, Humanitas Cancer Center, Humanitas Clinical and Research Center, Milan, Italy.
authors: R
authors: R
authors: Crocchiolo
authors: S
authors: S
authors: Bramanti
authors: A
authors: A
authors: Vai
authors: B
authors: B
authors: Sarina
authors: R
authors: R
authors: Mineri
authors: E
authors: E
authors: Casari
authors: F
authors: F
authors: Tordato
authors: E
authors: E
authors: Mauro
authors: I
authors: I
authors: Timofeeva
authors: E
authors: E
authors: Lugli
authors: D
authors: D
authors: Mavilio
authors: C
authors: C
authors: Carlo-Stella
authors: A
authors: A
authors: Santoro
authors: L
authors: L
authors: Castagna
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D015331:Cohort Studies; D003520:Cyclophosphamide / Q000008:administration & dosage* / Q000009:adverse effects; D003556:Cystitis / Q000453:epidemiology / Q000209:etiology / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000209:etiology / Q000276:immunology; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control*; D006239:Haplotypes; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D027601:Polyomavirus Infections / Q000453:epidemiology / Q000209:etiology / Q000276:immunology; D011446:Prospective Studies; D019172:Transplantation Conditioning; D014777:Virus Diseases / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide
keywords: T-cell replete; antimicrobial prophylaxis; cyclophosphamide; haploidentical stem cell transplantation; hematologic malignancies; infections
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