1. Infectious Complications in Patients With Multiple Myeloma After High-Dose Chemotherapy Followed by Autologous Stem Cell Transplant: Nationwide Study of the Infectious Complications Study Group of the Polish Adult Leukemia Group
- Author
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Alicja Sadowska-Klasa, Slawomira Kyrcz-Krzemien, Piotr Rzepecki, Sebastian Giebel, Mariola Sedzimirska, Lidia Gil, Agnieszka Tomaszewska, Monika Adamska, Joanna Romejko-Jarosinska, Natalia Winciorek, Wiesław Wiktor Jędrzejczak, Monika Biernat, Grzegorz W. Basak, Joanna Drozd-Sokołowska, Jan Styczyński, Joanna Mańko, Agnieszka Piekarska, Marek Hus, Agnieszka Wierzbowska, Patrycja Mensah-Glanowska, Jarosław Dybko, and Anna Waszczuk-Gajda
- Subjects
Adult ,Male ,medicine.medical_specialty ,Transplantation Conditioning ,Infections ,Transplantation, Autologous ,Immunocompromised Host ,Young Adult ,Postoperative Complications ,Risk Factors ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Epidemiology ,medicine ,Humans ,Multiple myeloma ,Aged ,Retrospective Studies ,Transplantation ,business.industry ,Incidence (epidemiology) ,Hematopoietic Stem Cell Transplantation ,Retrospective cohort study ,Odds ratio ,Middle Aged ,medicine.disease ,Leukemia ,Cross-Sectional Studies ,Etiology ,Female ,Surgery ,Poland ,Multiple Myeloma ,business - Abstract
Background Multiple myeloma (MM) has become a chronic disease in majority of patients, and remission consolidation with autologous hematopoietic stem cell transplant (ASCT) remains the backbone of treatment in transplant-eligible patients. Objective The aim of this multicenter cross-sectional nationwide retrospective study was to evaluate the epidemiology, etiology, and outcome of infections in patients with MM undergoing ASCT in 13 Polish transplant centers, carried out on behalf of the Infectious Complications Study Group of the Polish Adult Leukemia Group. Methods A total number of consecutive 1374 patients with MM treated in Polish adult transplant centers from 2012 to 2014 were followed for infectious complications up to day +100 after ASCT in nationwide study. Results Altogether 490 infection episodes in 336 patients (49% male, aged 21-72 years) were reported, including 145 episodes of neutropenic fever (103 patients) and 34 episodes of clinically documented infections (CDIs) (27 patients). Among microbiologically confirmed infections there were 251 episodes of bacterial infections (180 patients), 42 episodes of fungal infections (38 patients), and 18 episodes of viral infections (17 patients). The overall incidence of infections reached 13.1% for bacterial, 3.6% for fungal, and 1.3% for viral infections. There were 16 cases of infection-related deaths after ASCT (1.2%). The mortality risk factors included multidrug-resistant bacteria etiology (odds ratio [OR], 3.5; P = .033), coexistence of bacterial and fungal infection (OR, 6.3; P = .002), and CDI (OR, 5.5; P = .007). Conclusion ASCT in patients with MM was connected with low risk of life-threatening infections. However, multidrug-resistant bacteria bacterial etiology, mixed etiology, and CDI increased the risk of fatal outcome.
- Published
- 2020
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