Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation

Celalettin Ustun, Jo Anne H. Young, Genovefa A. Papanicolaou, Soyoung Kim, Kwang Woo Ahn, Min Chen, Hisham Abdel-Azim, Mahmoud Aljurf, Amer Beitinjaneh, Valerie Brown, Jan Cerny, Saurabh Chhabra, Mohamed A. Kharfan-Dabaja, Parastoo B. Dahi, Andrew Daly, Christopher E. Dandoy, Christopher C. Dvorak, Cesar O. Freytes, Shahrukh Hashmi, Hillard Lazarus & 13 others Per Ljungman, Taiga Nishihori, Kristin Page, Sai R.K. Pingali, Ayman Saad, Bipin N. Savani, Daniel Weisdorf, Kirsten Williams, Baldeep Wirk, Jeffery J. Auletta, Caroline A. Lindemans, Krishna Komanduri, Marcie Riches

Research output: Contribution to journalArticle

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Abstract

We analyzed CIBMTR data to evaluate the incidence of non-relapse mortality (NRM) and association with overall survival (OS) for bacterial blood stream infections (BSIs) occurring within 100 days of alloHCT in 2 different phases: pre-/peri-engraftment (BSI very early phase, BSI-VEP) and BSI post-engraftment (BSI occurring between 2 weeks after engraftment and day 100, late early phase, BSI-LEP). Of the 7128 alloHCT patients, 2656 (37%) had ≥1 BSI by day 100. BSI-VEP, BSI-LEP, and BSI-Both constituted 56% (n = 1492), 31% (n = 824), and 13% (n = 340) of total BSI, respectively. Starting in 2009, we observed a gradual decline in BSI incidence through 2012 (61–48%). Patients with BSI-VEP were more likely to receive a myeloablative conditioning (MAC) regimen with total body irradiation (TBI). NRM was significantly higher in patients with any BSI (RR 1.82 95% CI 1.63–2.04 for BSI-VEP, RR 2.46, 95% CI 2.05–2.96 for BSI-LEP, and RR 2.29, 95% CI 1.87–2.81 for BSI-Both) compared with those without BSI. OS was significantly lower in patients with any BSI compared with patients without BSI (RR 1.36, 95% CI 1.26–1.47 for BSI-VEP; RR 1.83, 95% CI 1.58–2.12 for BSI-LEP: RR 1.66, 95% CI 1.43–1.94 for BSI-Both). BSIs within day 100 after alloHCT are common and remain a risk factor for mortality.

Original languageEnglish (US)
Pages (from-to)1254-1265
Number of pages12
JournalBone Marrow Transplantation
Volume54
Issue number8
DOIs
StatePublished - Aug 1 2019

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Cell Transplantation
Mortality
Infection

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Ustun, Celalettin ; Young, Jo Anne H. ; Papanicolaou, Genovefa A. ; Kim, Soyoung ; Ahn, Kwang Woo ; Chen, Min ; Abdel-Azim, Hisham ; Aljurf, Mahmoud ; Beitinjaneh, Amer ; Brown, Valerie ; Cerny, Jan ; Chhabra, Saurabh ; Kharfan-Dabaja, Mohamed A. ; Dahi, Parastoo B. ; Daly, Andrew ; Dandoy, Christopher E. ; Dvorak, Christopher C. ; Freytes, Cesar O. ; Hashmi, Shahrukh ; Lazarus, Hillard ; Ljungman, Per ; Nishihori, Taiga ; Page, Kristin ; Pingali, Sai R.K. ; Saad, Ayman ; Savani, Bipin N. ; Weisdorf, Daniel ; Williams, Kirsten ; Wirk, Baldeep ; Auletta, Jeffery J. ; Lindemans, Caroline A. ; Komanduri, Krishna ; Riches, Marcie. / Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation. In: Bone Marrow Transplantation. 2019 ; Vol. 54, No. 8. pp. 1254-1265.
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title = "Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation",
abstract = "We analyzed CIBMTR data to evaluate the incidence of non-relapse mortality (NRM) and association with overall survival (OS) for bacterial blood stream infections (BSIs) occurring within 100 days of alloHCT in 2 different phases: pre-/peri-engraftment (BSI very early phase, BSI-VEP) and BSI post-engraftment (BSI occurring between 2 weeks after engraftment and day 100, late early phase, BSI-LEP). Of the 7128 alloHCT patients, 2656 (37{\%}) had ≥1 BSI by day 100. BSI-VEP, BSI-LEP, and BSI-Both constituted 56{\%} (n = 1492), 31{\%} (n = 824), and 13{\%} (n = 340) of total BSI, respectively. Starting in 2009, we observed a gradual decline in BSI incidence through 2012 (61–48{\%}). Patients with BSI-VEP were more likely to receive a myeloablative conditioning (MAC) regimen with total body irradiation (TBI). NRM was significantly higher in patients with any BSI (RR 1.82 95{\%} CI 1.63–2.04 for BSI-VEP, RR 2.46, 95{\%} CI 2.05–2.96 for BSI-LEP, and RR 2.29, 95{\%} CI 1.87–2.81 for BSI-Both) compared with those without BSI. OS was significantly lower in patients with any BSI compared with patients without BSI (RR 1.36, 95{\%} CI 1.26–1.47 for BSI-VEP; RR 1.83, 95{\%} CI 1.58–2.12 for BSI-LEP: RR 1.66, 95{\%} CI 1.43–1.94 for BSI-Both). BSIs within day 100 after alloHCT are common and remain a risk factor for mortality.",
author = "Celalettin Ustun and Young, {Jo Anne H.} and Papanicolaou, {Genovefa A.} and Soyoung Kim and Ahn, {Kwang Woo} and Min Chen and Hisham Abdel-Azim and Mahmoud Aljurf and Amer Beitinjaneh and Valerie Brown and Jan Cerny and Saurabh Chhabra and Kharfan-Dabaja, {Mohamed A.} and Dahi, {Parastoo B.} and Andrew Daly and Dandoy, {Christopher E.} and Dvorak, {Christopher C.} and Freytes, {Cesar O.} and Shahrukh Hashmi and Hillard Lazarus and Per Ljungman and Taiga Nishihori and Kristin Page and Pingali, {Sai R.K.} and Ayman Saad and Savani, {Bipin N.} and Daniel Weisdorf and Kirsten Williams and Baldeep Wirk and Auletta, {Jeffery J.} and Lindemans, {Caroline A.} and Krishna Komanduri and Marcie Riches",
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Ustun, C, Young, JAH, Papanicolaou, GA, Kim, S, Ahn, KW, Chen, M, Abdel-Azim, H, Aljurf, M, Beitinjaneh, A, Brown, V, Cerny, J, Chhabra, S, Kharfan-Dabaja, MA, Dahi, PB, Daly, A, Dandoy, CE, Dvorak, CC, Freytes, CO, Hashmi, S, Lazarus, H, Ljungman, P, Nishihori, T, Page, K, Pingali, SRK, Saad, A, Savani, BN, Weisdorf, D, Williams, K, Wirk, B, Auletta, JJ, Lindemans, CA, Komanduri, K & Riches, M 2019, 'Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation', Bone Marrow Transplantation, vol. 54, no. 8, pp. 1254-1265. https://doi.org/10.1038/s41409-018-0401-4

Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation. / Ustun, Celalettin; Young, Jo Anne H.; Papanicolaou, Genovefa A.; Kim, Soyoung; Ahn, Kwang Woo; Chen, Min; Abdel-Azim, Hisham; Aljurf, Mahmoud; Beitinjaneh, Amer; Brown, Valerie; Cerny, Jan; Chhabra, Saurabh; Kharfan-Dabaja, Mohamed A.; Dahi, Parastoo B.; Daly, Andrew; Dandoy, Christopher E.; Dvorak, Christopher C.; Freytes, Cesar O.; Hashmi, Shahrukh; Lazarus, Hillard; Ljungman, Per; Nishihori, Taiga; Page, Kristin; Pingali, Sai R.K.; Saad, Ayman; Savani, Bipin N.; Weisdorf, Daniel; Williams, Kirsten; Wirk, Baldeep; Auletta, Jeffery J.; Lindemans, Caroline A.; Komanduri, Krishna; Riches, Marcie.

In: Bone Marrow Transplantation, Vol. 54, No. 8, 01.08.2019, p. 1254-1265.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation

AU - Ustun, Celalettin

AU - Young, Jo Anne H.

AU - Papanicolaou, Genovefa A.

AU - Kim, Soyoung

AU - Ahn, Kwang Woo

AU - Chen, Min

AU - Abdel-Azim, Hisham

AU - Aljurf, Mahmoud

AU - Beitinjaneh, Amer

AU - Brown, Valerie

AU - Cerny, Jan

AU - Chhabra, Saurabh

AU - Kharfan-Dabaja, Mohamed A.

AU - Dahi, Parastoo B.

AU - Daly, Andrew

AU - Dandoy, Christopher E.

AU - Dvorak, Christopher C.

AU - Freytes, Cesar O.

AU - Hashmi, Shahrukh

AU - Lazarus, Hillard

AU - Ljungman, Per

AU - Nishihori, Taiga

AU - Page, Kristin

AU - Pingali, Sai R.K.

AU - Saad, Ayman

AU - Savani, Bipin N.

AU - Weisdorf, Daniel

AU - Williams, Kirsten

AU - Wirk, Baldeep

AU - Auletta, Jeffery J.

AU - Lindemans, Caroline A.

AU - Komanduri, Krishna

AU - Riches, Marcie

PY - 2019/8/1

Y1 - 2019/8/1

N2 - We analyzed CIBMTR data to evaluate the incidence of non-relapse mortality (NRM) and association with overall survival (OS) for bacterial blood stream infections (BSIs) occurring within 100 days of alloHCT in 2 different phases: pre-/peri-engraftment (BSI very early phase, BSI-VEP) and BSI post-engraftment (BSI occurring between 2 weeks after engraftment and day 100, late early phase, BSI-LEP). Of the 7128 alloHCT patients, 2656 (37%) had ≥1 BSI by day 100. BSI-VEP, BSI-LEP, and BSI-Both constituted 56% (n = 1492), 31% (n = 824), and 13% (n = 340) of total BSI, respectively. Starting in 2009, we observed a gradual decline in BSI incidence through 2012 (61–48%). Patients with BSI-VEP were more likely to receive a myeloablative conditioning (MAC) regimen with total body irradiation (TBI). NRM was significantly higher in patients with any BSI (RR 1.82 95% CI 1.63–2.04 for BSI-VEP, RR 2.46, 95% CI 2.05–2.96 for BSI-LEP, and RR 2.29, 95% CI 1.87–2.81 for BSI-Both) compared with those without BSI. OS was significantly lower in patients with any BSI compared with patients without BSI (RR 1.36, 95% CI 1.26–1.47 for BSI-VEP; RR 1.83, 95% CI 1.58–2.12 for BSI-LEP: RR 1.66, 95% CI 1.43–1.94 for BSI-Both). BSIs within day 100 after alloHCT are common and remain a risk factor for mortality.

AB - We analyzed CIBMTR data to evaluate the incidence of non-relapse mortality (NRM) and association with overall survival (OS) for bacterial blood stream infections (BSIs) occurring within 100 days of alloHCT in 2 different phases: pre-/peri-engraftment (BSI very early phase, BSI-VEP) and BSI post-engraftment (BSI occurring between 2 weeks after engraftment and day 100, late early phase, BSI-LEP). Of the 7128 alloHCT patients, 2656 (37%) had ≥1 BSI by day 100. BSI-VEP, BSI-LEP, and BSI-Both constituted 56% (n = 1492), 31% (n = 824), and 13% (n = 340) of total BSI, respectively. Starting in 2009, we observed a gradual decline in BSI incidence through 2012 (61–48%). Patients with BSI-VEP were more likely to receive a myeloablative conditioning (MAC) regimen with total body irradiation (TBI). NRM was significantly higher in patients with any BSI (RR 1.82 95% CI 1.63–2.04 for BSI-VEP, RR 2.46, 95% CI 2.05–2.96 for BSI-LEP, and RR 2.29, 95% CI 1.87–2.81 for BSI-Both) compared with those without BSI. OS was significantly lower in patients with any BSI compared with patients without BSI (RR 1.36, 95% CI 1.26–1.47 for BSI-VEP; RR 1.83, 95% CI 1.58–2.12 for BSI-LEP: RR 1.66, 95% CI 1.43–1.94 for BSI-Both). BSIs within day 100 after alloHCT are common and remain a risk factor for mortality.

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U2 - 10.1038/s41409-018-0401-4

DO - 10.1038/s41409-018-0401-4

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JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

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