Multiple bloodstream infections in pediatric stem cell transplant recipients: A case series.
Liron GrossmannPriscila Badia AlonsoAdam NelsonJavier El-BietarKasiani C MyersAdam LaneHeidi AndersenDavid HaslamSonata JodeleStella M DaviesChristopher E DandoyPublished in: Pediatric blood & cancer (2018)
Bacterial bloodstream infections (BSIs) are associated with poor outcomes following stem cell transplantation (SCT). We describe the demographics, treatment, complications, and outcome of 23 pediatric SCT recipients who developed three or more BSIs in the first year after SCT at our center from 2011 through 2016. The majority underwent allogeneic SCT (n = 22/23;96%), mainly from an unrelated donor (n = 19/22,86%); developed grade 2-4 graft versus host disease (GVHD; n = 14/23, 61%), all steroid refractory; and were diagnosed with thrombotic microangiopathy (n = 21/23, 91%). One-year overall survival was 56% (n = 13/23). We observed a high rate of transplant-associated thrombotic microangiopathy and steroid-refractory acute GVHD in patients with three or more BSIs.
Keyphrases
- stem cell transplantation
- high dose
- stem cells
- allogeneic hematopoietic stem cell transplantation
- liver failure
- respiratory failure
- risk factors
- low dose
- acute myeloid leukemia
- drug induced
- bone marrow
- combination therapy
- acute lymphoblastic leukemia
- intensive care unit
- kidney transplantation
- cord blood
- hepatitis b virus
- aortic dissection
- cell therapy
- childhood cancer
- mechanical ventilation