Contents

A Survey of Infection in Allogenic Hematopoietic Stem Cell Transplantation in Patients with Acute Myeloid Leukemia

Abstract

Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially cure for acute myeloid leukemia (AML). Patients who undergone HSCT are at increased risk of infection due to impaired immunity.

Objective: To evaluate the rate of bacterial, viral and fungal infection and its relationship with 2-year overall survival of AML patients who had undergone HSCT.

Methods: This was a retrospective cross-sectional study of 49 patients who underwent allogenic bone marrow transplantation (BMT) from full-matched donors at BMT Center, Imam Khomeini Hospital Complex, Tehran, Iran, from 2006 to 2013. All autologous transplantations and promyelocytic leukemia (PML) transplantations were excluded.

Results: All patients, except for one, had fever for a mean of 7 days post-transplantation and received broad-spectrum antibiotic. The rate of severe sepsis was 6.1%. None of the patients developed fungal infection during admission. The rate of admission due to sepsis after discharge was 27% in the alive group (mean onset of 54 days), and 73% in the deceased group (mean onset of 52 days) (p<0.05). The most common site of infection was lung (70%). The rate of cytomegalovirus (CMV) antigenemia (positive PP65) was 20% during the 2-year period after HSCT.

Conclusion: The rate of infection was a negative prognostic factor for 2-year overall survival. The rate of CMV antigenemia is less than similar studies (51%), which could be due to full-matched donor-recipients requiring less immunosuppression.

Keywords: Bone marrow transplantation; Infection; Acute myeloid leukemia
Copyright © 2018 S R Safayi, F Shahi, M Ghalamkari, M Mirzania, M Khatuni, F Hirmandi Niasar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.