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Averjanova et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract20
© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation",
Saint Petersburg, Russia, September 18–20, 2010

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Bacterial infections in children after stem cell transplantation

Marija Yu. Averjanova, Vladimir N. Vavilov, Ludmila S. Zubarovskaya, Boris V. Afanasyev

R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation of Pavlov State Medical University, Saint-Petersburg, Russia

Correspondence: Marija Yu. Averjanova, R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Pavlov State Medical University, 6/8, L. Tolstoy str., Saint-Petersburg, 197022, Russia, E-mail: 26112008@spam is badrambler.ru

Abstract

Background: Allogenic hemopoietic stem cell transplantation (alloHSCT) as well as intensive immunosuppression therapy leads to a marked immunodeficiency in alloHSCT recipients. Development of severe infections is one of the most serious events in the post-transplant period.

Aim: An analysis of the structure of bacterial complications, and a spectrum of microbial causative agents in patients with oncohematological diseases after alloHSCT in correlation with the time to engraftment and graft-versus-host disease (GVHD) course. 

Patients and methods:
94 alloHSCT patients within a range of the beginning of conditioning regimen and the 200th day after transplantation were included in the study.

Results: In the analyzed group, the median period of agranulocytosis was 6 days (1–54). Febrile neutropenia was observed in 70% of patients. Among all infectious complications 15% were bacterial infections (BI) documented in early pre-engraftment period. In the non-GVHD group (37 children) BI accounted for 25%. The highest incidence (60% of all BI) was noted in the patients with GVHD (57 children) without definite correlation with type of conditioning and duration of neutropenia. The most common BI that developed at different time intervals after HSCT were bacteremia (36%), lower respiratory tract (25%), and urinary tract (19%) infections. Gram-negative pathogens caused 59% of BI, including (Klebsiella pneumoniae 19%, Pseudomonas spp. 14%, Escherichia Coli 12%, and Enterobacter spp. 8%).

Conclusions: The duration of agranulocytosis and conditioning regimens do not influence the frequency of bacterial complications. Development of severe infections was to a large extent associated with the course of GVHD and its treatment.

Keywords: allogenic stem cells transplantation, GVHD, bacterial infections

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