Infectious complications after hematopoietic stem cell transplantation: current status and future perspectives in Korea

Cho, Sung‐Yeon; Lee, Hyeon Jeong; Lee, Dong Gun

doi:10.3904/kjim.2018.036

Cited by 50 publications

(49 citation statements)

References 150 publications

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“…Furthermore, mucositis is not only the commonest symptom of HSCT but it is also the most distressing complication, and about 30-50% of patients with HSCT complain that mucositis is the most toxic to them (Bellm, Epstein, Rose-Ped, Martin, & Fuchs, 2000). In Korea, HSCT procedure was first performed in patients in 1983, and transplants have increased rapidly over the past 35 years (Cho, Lee, & Lee, 2018).…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of clinical symptoms of chemotherapy‐induced oral mucositis in adult patients with acute leukemia: A preliminary study

Lee

Hong

Kim

et al. 2019

Clinical & Exp Dental Res

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Objective The objective of this study was to prospectively evaluate the clinical features of chemotherapy‐induced oral mucositis (CIOM) in adult patients with acute leukemia and the aggravating factors for such symptoms. Subjects Thirty‐seven prospective patients aged ≥19 years with acute leukemia undergoing chemotherapy were enrolled. Oral and clinical investigations were performed at baseline and on Day 14 after starting chemotherapy. The presence and severity of cancer‐induced oral mucositis were demonstrated using the World Health Organization (WHO) scoring system. Results On Day 14, we found that oral mucositis had developed in eight patients (21.6%). Hematopoietic stem cell transplantation (HSCT) in patients was a predictor of increased WHO scores (β = 1.937, p < .001). Regarding oral sites, ventral tongue (β = 1.670), soft palate (β = 1.242), and buccal mucosa (β = 0.593) were predictors for increased scores. In addition, the increase in WHO scores was positively correlated with the number of oral lesions (r = .521), the difficulty in eating (r = .250), and the overall oral health (r = .534; all p < .05). Conclusion The main factors affecting the severity of CIOM symptoms were the treatment with HSCT and the location of oral lesions. The incidence of CIOM and WHO scores were not significantly different between the subgroups of disease. Our findings will help clinicians investigate the oral findings after chemotherapy in adult patients with acute leukemia.

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Section: Discussionmentioning

confidence: 99%

Prospective evaluation of clinical symptoms of chemotherapy‐induced oral mucositis in adult patients with acute leukemia: A preliminary study

Lee

Hong

Kim

et al. 2019

Clinical & Exp Dental Res

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“…Specific treatment was not initiated at the time of CMV/EBV reactivation until the development of CMV disease or EBV-related disease. 4 This prospective observational study was approved by the Institutional Review Board of Seoul St. Mary's Hospital (KC15RISI0071) and was conducted in accordance with the Declaration of Helsinki. Informed consent was obtained from all patients before being included in the study.…”

Section: Patient Selectionmentioning

confidence: 99%

Reactivation and dynamics of cytomegalovirus and Epstein‐Barr virus after rabbit antithymocyte globulin and cyclosporine for aplastic anemia

Park

Cho

Han

et al. 2019

European J of Haematology

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Objectives This study aimed to identify the natural course of cytomegalovirus (CMV)/Epstein‐Barr virus (EBV) after rabbit antithymocyte globulin and cyclosporine (rATG‐CsA) for aplastic anemia (AA). Methods In 113 prospectively observed AA patients treated with rATG‐CsA, the CMV/EBV cohort was classified into two groups by baseline viremic status: no viremia (CMV‐G1, n = 112; EBV‐G1, n = 98) and the presence of viremia (CMV‐G2, n = 1; EBV‐G2, n = 13). Results In CMV‐G1, the mean CMV load increased up to 3 months but was completely resolved from 6 months. The mean EBV load of EBV‐G1 showed a peak at 1 month and then gradually decreased over time but remained detectable throughout the observation period. EBV‐G2 showed fluctuating EBV dynamics. With reactivation rates of 38.4% in CMV‐G1 and 62.2% in EBV‐G1, a longer time to rATG‐CsA from diagnosis and a lower absolute lymphocyte count at 1 month from rATG‐CsA were significantly associated with CMV and EBV reactivation, respectively. The mean peak CMV and EBV loads of patients with CMV‐related (3.5%) and EBV‐related (0.9%) diseases were evidently higher than those of the remaining patients without CMV and EBV diseases in the respective cohort. Conclusion Considering frequent reactivation and distinct courses of CMV/EBV, virologic surveillance is recommended after rATG‐CsA for AA.

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“…In immunocompetent patients, RVs generally cause self-limited upper respiratory tract infections (URTI). However, RVs are associated with poor prognosis in immunocompromised hosts [8][9][10][11][12]. Traditionally, viral culture has been considered the gold standard for diagnosing RV infection [13].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Clinical Course of Upper Airway Respiratory Virus Infection in Critically Ill Patients with Hematologic Malignancies

J¹,

Kim²,

Rhee³

et al. 2020

Preprint

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Background The clinical significance of upper airway respiratory virus (RV) detection in patients with hematologic malignancies remains unclear. We aimed to investigate the association between upper airway RV detection and prognosis in critically ill patients with hematologic malignancies. Methods This retrospective observational study included 331 critically ill patients with hematologic malignancies who presented respiratory symptoms and their nasopharyngeal swab was tested using a multiplex PCR assay between January 2017 and December 2018. A logistic regression model was used to adjust for potential confounding factors in the association between assay positivity and in-hospital mortality. Results Among the 331 analyzed patients, RVs were detected in 29.0%. The overall mortality rates in the intensive care unit and hospital were 56.8% and 65.9%, respectively. Positive upper airway RV detection was associated with relapsed hematologic malignancies, higher level of C-reactive protein, and prior use of high dose steroids and anti-cancer chemotherapeutic drugs. Furthermore, it was independently associated with in-hospital mortality (adjusted odds ratio, 2.36; 95% confidence interval, 1.23 to 4.54). Among different RVs, parainfluenza virus was more prevalent among patients who died in the hospital than among those who survived (11.5% vs. 3.5%, P = 0.027). Conclusions RV detection in the upper respiratory tract was relatively common in our cohort and was significantly associated with a poor prognosis. Thus, it can be used as a predictor of prognosis. Moreover, RV presence in the upper respiratory tract should be examined in patients who have previously been prescribed with high dose corticosteroids and anti-cancer drugs.

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Infectious complications after hematopoietic stem cell transplantation: current status and future perspectives in Korea

Cited by 50 publications

References 150 publications

Prospective evaluation of clinical symptoms of chemotherapy‐induced oral mucositis in adult patients with acute leukemia: A preliminary study

Prospective evaluation of clinical symptoms of chemotherapy‐induced oral mucositis in adult patients with acute leukemia: A preliminary study

Reactivation and dynamics of cytomegalovirus and Epstein‐Barr virus after rabbit antithymocyte globulin and cyclosporine for aplastic anemia

Prevalence and Clinical Course of Upper Airway Respiratory Virus Infection in Critically Ill Patients with Hematologic Malignancies

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