Mycobacterial infections in adult recipients of allogeneic hematopoietic stem cell transplantation: A cohort study in a high endemic area
Background: Mycobacterial infections are important and potentially life-threatening complications after organ transplantations. Notably, for the recipients of allogeneic hematopoietic stem cell transplantation (HSCT), there are a few supporting results to explore post-transplant mycobacterial infect...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-04-01
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| Series: | Journal of Microbiology, Immunology and Infection |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S168411821830269X |
| _version_ | 1818216218536968192 |
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| author | Yao-Chung Liu Chi-Jung Wu Po-Shen Ko Sheng-Hsuan Chien Nai-Wen Fan Hao-Yuan Wang Jyh-Pyng Gau Chia-Jen Liu Liang-Tsai Hsiao Tzeon-Jye Chiou Chun-Yu Liu Jin-Hwang Liu |
| author_facet | Yao-Chung Liu Chi-Jung Wu Po-Shen Ko Sheng-Hsuan Chien Nai-Wen Fan Hao-Yuan Wang Jyh-Pyng Gau Chia-Jen Liu Liang-Tsai Hsiao Tzeon-Jye Chiou Chun-Yu Liu Jin-Hwang Liu |
| author_sort | Yao-Chung Liu |
| collection | DOAJ |
| description | Background: Mycobacterial infections are important and potentially life-threatening complications after organ transplantations. Notably, for the recipients of allogeneic hematopoietic stem cell transplantation (HSCT), there are a few supporting results to explore post-transplant mycobacterial infections. Taiwan is a high endemic area of the infection. We aim to investigate the incidence, risk factors, and survival of post-transplant mycobacterial infections, including mycobacterium tuberculosis (MTB) and non-tuberculous mycobacterium (NTM). Methods: We included 422 adult patients undergoing allogeneic HSCT at an Asian tertiary medical center between January 2003 and December 2014. A total 26 subjects developed post-transplant mycobacterial infections. Risk factors, clinical features, and survival for post-transplant mycobacterial infections were collected and analyzed. Results: Post-transplant mycobacterial infections occurred in 26 (6.2%) of 422 HSCT patients. Two-year cumulative incidences in MTB and NTM were 1.4% and 5.4%. In the multivariate analysis, being age >45 years (adjusted HR 2.21, 95% CI 1.01–4.83) and extensive chronic graft-versus-host disease (cGVHD) (adjusted HR 4.95, 95% CI 2.14–11.46) were identified as independent risk factors of infections. There was a trend as a risk factors in relapsed patients (P = 0.088). For patients with cGVHD, there was a significant difference of post-transplant survival between mycobacterial infections and none (P = 0.036). Pneumonia contributed most to mortality (n = 11, 42.3%). Conclusion: Mycobacterial infections are worth to note in a high endemic area. Once a high-risk group is identified, much effort is required to target new approaches for prevention, early detection and treatment of infections. Keywords: Hematopoietic stem cell transplantation, Mycobacterial infections, Mycobacterium tuberculosis, Non-tuberculous mycobacterium, Graft-versus-host disease |
| first_indexed | 2024-12-12T06:48:29Z |
| format | Article |
| id | doaj.art-3263dede27524e0ab957a200576cd03a |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-12-12T06:48:29Z |
| publishDate | 2020-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-3263dede27524e0ab957a200576cd03a2022-12-22T00:34:06ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822020-04-01532274282Mycobacterial infections in adult recipients of allogeneic hematopoietic stem cell transplantation: A cohort study in a high endemic areaYao-Chung Liu0Chi-Jung Wu1Po-Shen Ko2Sheng-Hsuan Chien3Nai-Wen Fan4Hao-Yuan Wang5Jyh-Pyng Gau6Chia-Jen Liu7Liang-Tsai Hsiao8Tzeon-Jye Chiou9Chun-Yu Liu10Jin-Hwang Liu11Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Corresponding author. Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei, 112, Taiwan. Fax: 886 2 28757762.Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, TaiwanFaculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, TaiwanFaculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Transfusion Medicine, Taipei Veterans General Hospital, Taipei, TaiwanFaculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Transfusion Medicine, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Hematology and Oncology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, TaiwanBackground: Mycobacterial infections are important and potentially life-threatening complications after organ transplantations. Notably, for the recipients of allogeneic hematopoietic stem cell transplantation (HSCT), there are a few supporting results to explore post-transplant mycobacterial infections. Taiwan is a high endemic area of the infection. We aim to investigate the incidence, risk factors, and survival of post-transplant mycobacterial infections, including mycobacterium tuberculosis (MTB) and non-tuberculous mycobacterium (NTM). Methods: We included 422 adult patients undergoing allogeneic HSCT at an Asian tertiary medical center between January 2003 and December 2014. A total 26 subjects developed post-transplant mycobacterial infections. Risk factors, clinical features, and survival for post-transplant mycobacterial infections were collected and analyzed. Results: Post-transplant mycobacterial infections occurred in 26 (6.2%) of 422 HSCT patients. Two-year cumulative incidences in MTB and NTM were 1.4% and 5.4%. In the multivariate analysis, being age >45 years (adjusted HR 2.21, 95% CI 1.01–4.83) and extensive chronic graft-versus-host disease (cGVHD) (adjusted HR 4.95, 95% CI 2.14–11.46) were identified as independent risk factors of infections. There was a trend as a risk factors in relapsed patients (P = 0.088). For patients with cGVHD, there was a significant difference of post-transplant survival between mycobacterial infections and none (P = 0.036). Pneumonia contributed most to mortality (n = 11, 42.3%). Conclusion: Mycobacterial infections are worth to note in a high endemic area. Once a high-risk group is identified, much effort is required to target new approaches for prevention, early detection and treatment of infections. Keywords: Hematopoietic stem cell transplantation, Mycobacterial infections, Mycobacterium tuberculosis, Non-tuberculous mycobacterium, Graft-versus-host diseasehttp://www.sciencedirect.com/science/article/pii/S168411821830269X |
| spellingShingle | Yao-Chung Liu Chi-Jung Wu Po-Shen Ko Sheng-Hsuan Chien Nai-Wen Fan Hao-Yuan Wang Jyh-Pyng Gau Chia-Jen Liu Liang-Tsai Hsiao Tzeon-Jye Chiou Chun-Yu Liu Jin-Hwang Liu Mycobacterial infections in adult recipients of allogeneic hematopoietic stem cell transplantation: A cohort study in a high endemic area Journal of Microbiology, Immunology and Infection |
| title | Mycobacterial infections in adult recipients of allogeneic hematopoietic stem cell transplantation: A cohort study in a high endemic area |
| title_full | Mycobacterial infections in adult recipients of allogeneic hematopoietic stem cell transplantation: A cohort study in a high endemic area |
| title_fullStr | Mycobacterial infections in adult recipients of allogeneic hematopoietic stem cell transplantation: A cohort study in a high endemic area |
| title_full_unstemmed | Mycobacterial infections in adult recipients of allogeneic hematopoietic stem cell transplantation: A cohort study in a high endemic area |
| title_short | Mycobacterial infections in adult recipients of allogeneic hematopoietic stem cell transplantation: A cohort study in a high endemic area |
| title_sort | mycobacterial infections in adult recipients of allogeneic hematopoietic stem cell transplantation a cohort study in a high endemic area |
| url | http://www.sciencedirect.com/science/article/pii/S168411821830269X |
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