Central nervous system infection following allogeneic hematopoietic stem cell transplantation.
OBJECTIVE
Here, we described the clinical characteristics and outcomes of central nervous system (CNS) infections occurring after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in a single institution over the previous 6 years.


METHODS
Charts of 353 consecutive allogeneic transplant recipients were retrospectively reviewed for CNS infection.


RESULTS
A total of 17 cases of CNS infection were identified at a median of 38 days (range, 10-1028 days) after allo-HSCT. Causative pathogens were human herpesvirus-6 (n=6), enterococcus (n=2), staphylococcus (n=2), streptococcus (n=2), varicella zoster virus (n=1), cytomegalovirus (n=1), John Cunningham virus (n=1), adenovirus (n=1), and Toxoplasma gondii (n=1). The cumulative incidence of CNS infection was 4.1% at 1 year and 5.5% at 5 years.


CONCLUSIONS
Multivariate analysis revealed that high-risk disease status was a risk factor for developing CNS infection (p=.02), and that overall survival at 3 years after allo-HSCT was 33% in patients with CNS infection and 53% in those without CNS infection (p=.04).
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Ryo
R
Hanajiri
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Takeshi
T
Kobayashi
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Kosuke
K
Yoshioka
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Daisuke
D
Watanabe
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Kyoko
K
Watakabe
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Yutaka
Y
Murata
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Takeshi
T
Hagino
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Yasushi
Y
Seno
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Yuho
Y
Najima
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Aiko
A
Igarashi
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Noriko
N
Doki
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Kazuhiko
K
Kakihana
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Hisashi
H
Sakamaki
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan. Electronic address: k.ohashi@cick.jp.
Kazuteru
K
Ohashi
D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000150:complications / Q000382:microbiology; D002494:Central Nervous System Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D003587:Cytomegalovirus / Q000302:isolation & purification; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D015654:Herpesvirus 6, Human / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013210:Staphylococcus / Q000302:isolation & purification; D015996:Survival Rate; D014184:Transplantation, Homologous; D014777:Virus Diseases / Q000150:complications / Q000821:virology; D055815:Young Adult
Allogeneic hematopoietic stem cell transplantation; Central nervous system infections; Human herpesvirus 6