Epidemiology of early infections and predictors of mortality after autologous hematopoietic stem-cell transplantation among multiple myeloma, Hodgkin, and non-Hodgkin lymphoma: the first experience from Palestine

Abstract

Background Autologous hematopoietic stem-cell transplantation (HSCT) is the standard of care in many relapsed and refractory lymphoid malignancy, neuroblastoma, and multiple myeloma (MM). This study was conducted to describe the epidemiology of early infections that occurred within the first 100 days among patients who received HSCT for MM, Hodgkin (HL), and non-Hodgkin lymphoma (NHL) in Palestine. Methods This study was conducted in a retrospective cohort design in the only autologous HSCT in Palestine in the period between 2014 and 2021. The medical records of the patients were reviewed to identify and collect demographic, clinical, and microbiological data on bacterial, viral, fungal, and parasitic infections as diagnosed by cultures, polymerase chain reaction, and fluorescent antibody testing. Results A total of 145 patients were included in this study (median age = 44.0 [28.0, 53.5] years). Of those, 8 (5.5%) were younger than 18 years, 69 (47.6%) had MM, 53 (36.6%) had HL, and 23 (15.9%) had NHL. The source of fever had no focus in the majority of the cases 82 (56.6%), 12 (8.3%) had bloodstream infections, 8 (5.5%) had colitis, and 7.6 (5.0%) had pneumonia. Patients from whom gram-negative bacteria were isolated stayed in the hospital for longer duration compared to the other patients (median = 21.0 [19.0, 25.0] vs. 18.0 [15.0, 22.0] days, p-value = 0.043, respectively). The cumulative incidence of death in the first 100 days after infusion of stem cells was 3.4%. The cumulative incidence of death in the first 100 days post-transplantation was higher for patients with NHL compared to those with HL and MM (p-value = 0.017). Gram-negative and fungal infections were strong predictors of mortality. Conclusion Bacterial gram-positive and gram-negative infections were the most common early infections among patients who underwent autologous HSCT for hematological malignancies (HM) in the only center in Palestine. The findings of this study are informative to healthcare providers and planners of care for patients who are scheduled to receive autologous HSCT for HM.

Ciprofloxacin prophylaxis during haematopoietic cell transplantation: a role for use in patients with germ cell tumours?

“…Not all auto-HCT indications are associated with the same infection risk, and germ cell tumour patients are an understudied group due to the rarity of the condition. Indeed, most studies investigating infections after auto-HCT describe patients with lymphomas and multiple myeloma [11–14]. Our large cohort from a specialist referral centre allowed us to showcase that auto-HCT recipients with germ cell tumours had a higher risk of bacteraemia compared to these traditional transplant indications.…”

Composition of the Gut Microbiome and the Risk of Bacterial Infections in Patients with Hematopoietic Stem Cell Transplantation

“…Значительно чаще бактериальные инфекции регистрируются у пациентов после аллогенной ТГСК. Так, частота развития инфекции кровотока (ИК) у пациентов после аллогенной ТГСК составляет 9-40% и от 1% до 8% при аутологичной трансплантации соответственно [2][3][4]. Смертность при развитии ИК может составлять от 5% до 60%, в случае обнаружения полирезистентных штаммов.…”