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Infections after T‐replete haploidentical transplantation and high‐dose cyclophosphamide as graft‐versus‐host disease prophylaxis
Author(s) -
Crocchiolo R.,
Bramanti S.,
Vai A.,
Sarina B.,
Mineri R.,
Casari E.,
Tordato F.,
Mauro E.,
Timofeeva I.,
Lugli E.,
Mavilio D.,
CarloStella C.,
Santoro A.,
Castagna L.
Publication year - 2015
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12365
Subject(s) - medicine , cumulative incidence , cyclophosphamide , hematopoietic stem cell transplantation , incidence (geometry) , confidence interval , transplantation , cohort , hemorrhagic cystitis , prospective cohort study , immunology , chemotherapy , physics , optics
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. Method 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). Conclusion 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.