Journal
BONE MARROW TRANSPLANTATION
Volume 54, Issue 8, Pages 1254-1265Publisher
SPRINGERNATURE
DOI: 10.1038/s41409-018-0401-4
Keywords
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Categories
Funding
- Public Health Service from the National Cancer Institute (NCI) [5U24CA076518]
- National Heart, Lung and Blood Institute (NHLBI)
- National Institute of Allergy and Infectious Diseases (NIAID)
- NHLBI [4U10HL069294]
- NCI [4U10HL069294]
- Health Resources and Services Administration (HRSA/DHHS) [HHSH250201200016C]
- Office of Naval Research [N00014-17-1-2388, N0014-17-1-2850]
- Actinium Pharmaceuticals, Inc.
- Amgen, Inc.
- Amneal Biosciences
- Angiocrine Bioscience, Inc.
- Astellas Pharma US
- Atara Biotherapeutics, Inc.
- Be the Match Foundation
- bluebird bio, Inc.
- Bristol Myers Squibb Oncology
- Celgene Corporation
- Cerus Corporation
- Chimerix, Inc.
- Fred Hutchinson Cancer Research Center
- Gamida Cell Ltd.
- Gilead Sciences, Inc.
- HistoGenetics, Inc.
- Immucor
- Incyte Corporation
- Janssen Scientific Affairs, LLC
- Jazz Pharmaceuticals, Inc.
- Juno Therapeutics
- Karyopharm Therapeutics, Inc.
- Kite Pharma, Inc.
- Medac, GmbH
- MedImmune
- Medical College of Wisconsin
- Mediware
- Merck Co, Inc.
- Mesoblast
- MesoScale Diagnostics, Inc.
- Millennium
- Takeda Oncology Co.
- Miltenyi Biotec, Inc.
- National Marrow Donor Program
- Neovii Biotech NA, Inc.
- Novartis Pharmaceuticals Corporation
- Otsuka Pharmaceutical Co, Ltd. - Japan
- PCORI
- Pfizer, Inc
- Pharmacyclics, LLC
- PIRCHE AG
- Sanofi Genzyme
- Seattle Genetics
- Shire
- Spectrum Pharmaceuticals Inc.
- St. Baldrick's Foundation
- Sunesis Pharmaceuticals, Inc.
- Swedish Orphan Biovitrum, Inc.
- Takeda Oncology
- Telomere Diagnostics, Inc.
- University of Minnesota
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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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