Incidence and Risk Factors of Early Bacterial Infections after Unrelated Cord Blood Transplantation

Makoto Yazaki, Yoshiko Atsuta, Koji Kato, Shunichi Kato, Shuichi Taniguchi, Satoshi Takahashi, Hiroyasu Ogawa, Yasuji Kouzai, Takeshi Kobayashi, Masami Inoue, Ryoji Kobayashi, Tokiko Nagamura-Inoue, Hiroshi Azuma, Minoko Takanashi, Shunro Kai, Masao Nakabayashi, Hidehiko Saito

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Incidence and characteristics of early bacterial infection within 100 days after unrelated cord blood transplantation (UCBT) were assessed for 664 pediatric and 1208 adult recipients in Japan. Cumulative incidence of early bacterial infection at day 100 post-UCBT was 11% (95% confidence interval [CI], 8%-13%) for children and 21% (CI, 19%-24%) for adults (P < .0001). Early bacterial infection in adults had a significant impact on mortality (hazard ratio [HR] = 2.1, CI, 1.7-2.6; P < .0001), although no significant risk factors were identified. Multivariate analysis identified older age group (6-10, and 11-15 years versus 0-5 years of age) at transplant (HR = 2.0 and 2.7, CI, 1.1-3.5 and 1.4-4.9; P = .020 and .002, respectively) as an independent risk factor of early bacterial infection for children. Early bacterial infection in children did not have a significant impact on mortality when adjusted. Of 315 bacteremia, 74% were caused by Gram-positive microorganisms. Pneumonia occurred in 39 patients including 13 cases of Stenotrophomonas maltophilia pneumonia. Early bacterial infection had a negative effect on survival for adults and the median day of development was 10 days after transplant, suggesting that the prevention of bacterial infection in the very early post-UCBT phase is important.

Original languageEnglish
Pages (from-to)439-446
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume15
Issue number4
DOIs
Publication statusPublished - Apr 2009
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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