共 22 条
Incidence and Risk Factors for Nontuberculous Mycobacterial Infection after Allogeneic Hematopoietic Cell Transplantation
被引:26
作者:

Beswick, Jennifer
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Toronto, Dept Med, Toronto, ON, Canada Univ Toronto, Dept Med, Toronto, ON, Canada

Shin, Elizabeth
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Toronto, Univ Hlth Network, Princess Margaret Canc Ctr, Allogene Blood & Marrow Transplant Program,Dept M, Toronto, ON, Canada Univ Toronto, Dept Med, Toronto, ON, Canada

Michelis, Fotios V.
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Toronto, Univ Hlth Network, Princess Margaret Canc Ctr, Allogene Blood & Marrow Transplant Program,Dept M, Toronto, ON, Canada Univ Toronto, Dept Med, Toronto, ON, Canada

Thyagu, Santhosh
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Toronto, Univ Hlth Network, Princess Margaret Canc Ctr, Allogene Blood & Marrow Transplant Program,Dept M, Toronto, ON, Canada Univ Toronto, Dept Med, Toronto, ON, Canada

Viswabandya, Auro
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Toronto, Univ Hlth Network, Princess Margaret Canc Ctr, Allogene Blood & Marrow Transplant Program,Dept M, Toronto, ON, Canada Univ Toronto, Dept Med, Toronto, ON, Canada

Lipton, Jeffrey H.
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Toronto, Univ Hlth Network, Princess Margaret Canc Ctr, Allogene Blood & Marrow Transplant Program,Dept M, Toronto, ON, Canada Univ Toronto, Dept Med, Toronto, ON, Canada

Messner, Hans
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Toronto, Univ Hlth Network, Princess Margaret Canc Ctr, Allogene Blood & Marrow Transplant Program,Dept M, Toronto, ON, Canada Univ Toronto, Dept Med, Toronto, ON, Canada

Marras, Theodore K.
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Hlth Network, Div Respirol, Dept Med, Toronto, ON, Canada
Univ Toronto, 399 Bathurst St,7 East,Room 452, Toronto, ON M5T 2S8, Canada Univ Toronto, Dept Med, Toronto, ON, Canada

Kim, Dennis
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Toronto, Univ Hlth Network, Princess Margaret Canc Ctr, Allogene Blood & Marrow Transplant Program,Dept M, Toronto, ON, Canada Univ Toronto, Dept Med, Toronto, ON, Canada
机构:
[1] Univ Toronto, Dept Med, Toronto, ON, Canada
[2] Univ Toronto, Univ Hlth Network, Princess Margaret Canc Ctr, Allogene Blood & Marrow Transplant Program,Dept M, Toronto, ON, Canada
[3] Univ Hlth Network, Div Respirol, Dept Med, Toronto, ON, Canada
[4] Univ Toronto, 399 Bathurst St,7 East,Room 452, Toronto, ON M5T 2S8, Canada
关键词:
Hematopoietic stem cell transplantation;
Allogeneic hematopoietic stem cell transplantation;
Mycobacterium infections;
Nontuberculous;
Nontuberculous mycobacteria;
VERSUS-HOST-DISEASE;
CONSENSUS DEVELOPMENT PROJECT;
PREVALENCE;
DIAGNOSIS;
RECIPIENTS;
CRITERIA;
SCORE;
D O I:
10.1016/j.bbmt.2017.09.015
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
Allogenic hematopoietic stem cell transplant (HCT) recipients are at risk of many infections. Nontuberculous mycobacteria (NTM) are increasingly recognized as clinically significant pathogens in this population. We investigated the incidence and risk factors for NTM infection after allogeneic HCT. This retrospective cohort study included all patients with allogeneic HCT at our institution during 2001 to 2013. Patients who developed significant NTM infection (NTM disease) were identified. Multivariable modeling was used to identify risk factors for NTM disease, and a risk score model was constructed to identify high-risk patients. Of 1097 allogeneic HCT patients, 45 (4.1%) had NTM isolated and 30 (2.7%) had NTM disease (28 [93.3%] exclusively pulmonary, 2 [6.7%] pulmonary plus another site). Incidence of NTM infection by competing risk analysis was 2.8% at 5 years (95% CI, 1.9% to 4.0%). The median time to diagnosis was 343 days (range, 19 to 1967). In Fine-Gray proportional hazards modeling, only global severity of chronic graft-versus-host disease (cGVHD) (HR, 1.99; 95% CI, 1.12 to 3.53; P = .019,) and cytomegalovirus (CMV) viremia (HR, 5.77; 95% CI, 1.71 to 19.45; P = .004) were significantly associated with NTM disease. Using these variables a risk score was calculated: 1 point for CMV viremia or moderate cGVHD and 2 points for severe cGVHD. The score divided patients into low risk (0 to 1 points, n = 820 [77.3%], 3-year NTM risk 1.2%), intermediate risk (2 points, n = 161 [15.4%], 3-year NTM risk 7.1%), and high risk (3 points, n = 56 [5.4%], 3-year NTM risk 14.3%). NTM disease after allogeneic HCT is common. Severe cGVHD and CMV viremia are associated with increased risk, permitting risk stratification. (C) 2017 American Society for Blood and Marrow Transplantation.
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收藏
页码:366 / 372
页数:7
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Ha, Jick Hwan
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Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Internal Med, Seoul 137701, South Korea Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Internal Med, Seoul 137701, South Korea

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Catholic Univ Korea, Incheon St Marys Hosp, Dept Internal Med, Coll Med, Inchon 403720, South Korea Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Internal Med, Seoul 137701, South Korea

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Catholic Univ Korea, Yeouido St Marys Hosp, Coll Med, Dept Internal Med, Seoul 150713, South Korea Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Internal Med, Seoul 137701, South Korea

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Lee, Dong-Gun
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Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Internal Med, Seoul 137701, South Korea Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Internal Med, Seoul 137701, South Korea

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