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

被引：34

作者：

Yazaki, Makoto ^{[1
]}

Atsuta, Yoshiko ^{[2
]}

Kato, Koji ^{[3
]}

Kato, Shunichi ^{[4
]}

Taniguchi, Shuichi ^{[5
]}

Takahashi, Satoshi ^{[6
]}

Ogawa, Hiroyasu ^{[7
]}

Kouzai, Yasuji ^{[8
]}

Kobayashi, Takeshi ^{[9
]}

Inoue, Masami ^{[10
,11
]}

Kobayashi, Ryoji ^{[12
]}

Nagamura-Inoue, Tokiko ^{[13
]}

Azuma, Hiroshi ^{[14
]}

Takanashi, Minoko ^{[15
]}

Kai, Shunro ^{[16
]}

Nakabayashi, Masao ^{[17
]}

Saito, Hidehiko ^{[18
]}

机构：

[1] Nagaya City E Med Ctr, Dept Pediat, Chikusa Ku, Nagoya, Aichi 4648547, Japan

[2] Nagoya Univ, Sch Med, Dept HSCT Data Management, Nagoya, Aichi 466, Japan

[3] Japinese Red Cross Nagoya First Hosp, Childrens Med Ctr, Div Hematol Oncol, Nagoya, Aichi, Japan

[4] Tokai Univ, Sch Med, Dept Cell Transplantat & Regenerat Med, Isehara, Kanagawa 25911, Japan

[5] Toranomon Gen Hosp, Dept Hematol, Tokyo, Japan

[6] Univ Tokyo, Inst Med Sci, Adv Clin Res Ctr, Div Mol Therapy, Tokyo, Japan

[7] Hyogo Coll Med, Dept Internal Med, Div Hematol, Nishinomiya, Hyogo, Japan

[8] Tokyo Metropolitan Fuchu Gen Hosp, Dept Transfus Med, Fuchu, Tokyo, Japan

[9] Tokyo Metropolitan Komagome Hosp, Div Hematol, Tokyo, Japan

[10] Osaka Med Ctr, Dept Hematol Oncol, Izumi, Japan

[11] Res Inst Maternal & Child Hlth, Izumi, Japan

[12] Hokkaido Univ, Grad Sch Med, Dept Pediat, Sapporo, Hokkaido, Japan

[13] Univ Tokyo, Inst Med Sci, Res Hosp, Div Cell Proc & Transfus, Tokyo, Japan

[14] Hokkaido Red Cross Blood Ctr, Sapporo, Hokkaido, Japan

[15] Japanese Red Cross Tokyo Blood Ctr, Blood Preparat Dept, Tokyo, Japan

[16] Hyogo Coll Med, Dept Blood Transfus, Nishinomiya, Hyogo, Japan

[17] Aiiku Hosp, Dept Obstet Gynecol, Maternal & Child Hlth Ctr, Tokyo, Japan

[18] Nagoya Cent Hosp, Nagoya, Aichi, Japan

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2009年 / 15卷 / 04期

关键词：

Early bacterial infection; Cord blood transplantation; The Japan Cord Blood Bank Network; Risk factor for infection; Urelated donor; STEM-CELL TRANSPLANTATION; BONE-MARROW-TRANSPLANTATION; PLACENTAL-BLOOD; ADULT PATIENTS; DONORS; LEUKEMIA; MALIGNANCIES; ENGRAFTMENT; RECIPIENTS; KINETICS;

D O I：

10.1016/j.bbmt.2008.12.508

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 3 15 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.

引用

页码：439 / 446

页数：8

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