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Early and late invasive pneumococcal infection following stem cell transplantation: a European Bone Marrow Transplantation survey

Engelhard, D; Cordonnier, C; Shaw, PJ; Parkalli, T; Guenther, C; Martino, R; Dekker, AW; Prentice, HG; Gustavsson, Anita LU and Nurnberger, W, et al. (2002) In British Journal of Haematology 117(2). p.444-450
Abstract
Streptococcus pneumoniae (S. pneumoniae) may cause severe and lethal infections months and years following stem cell transplantation (SCT). In a prospective survey over a 3.5-year period, we assessed the incidence, risk factors and outcome for invasive pneumococcal infection (IPI) following SCT. Fifty-one episodes of IPI were reported: 43 episodes after bone marrow transplantation (BMT) and 8 after peripheral blood stem cell transplantation (PBSCT); 35 after allogeneic SCT and 16 after autologous SCT. Seven IPI episodes, all bacteraemias, were defined as early, occurring 1-35 d (median 3 d) post transplantation. Forty-four episodes were defined as late (greater than or equal to 100 d post SCT), occurring 4 months to 10 years (median 17... (More)
Streptococcus pneumoniae (S. pneumoniae) may cause severe and lethal infections months and years following stem cell transplantation (SCT). In a prospective survey over a 3.5-year period, we assessed the incidence, risk factors and outcome for invasive pneumococcal infection (IPI) following SCT. Fifty-one episodes of IPI were reported: 43 episodes after bone marrow transplantation (BMT) and 8 after peripheral blood stem cell transplantation (PBSCT); 35 after allogeneic SCT and 16 after autologous SCT. Seven IPI episodes, all bacteraemias, were defined as early, occurring 1-35 d (median 3 d) post transplantation. Forty-four episodes were defined as late (greater than or equal to 100 d post SCT), occurring 4 months to 10 years (median 17 months) post transplantation. The incidences of early and late IPI were 2.03/1000 and 8.63/1000 transplantations respectively (P = 0.001). A higher incidence of late IPI was observed after BMT than after PBSCT (10.99 versus 3.23/1000; P < 0.01) and after allogeneic versus autologous SCT (12.20 versus 4.60/1000; P < 0.01). There was a higher estimated incidence of IPI in allogeneic patients with than in those without graft-versus-host disease (GVHD) (18.85 versus 8.25/1000; P = 0.015). The mortality rate was 20%, including 2/7 of early and 8/44 of late IPI. S. pneumoniae is a rare but important complication during the aplastic phase after SCT. In conclusion, S. pneumoniae is a significant cause of morbidity late post-transplantation, especially in allogeneic patients, and particularly those with GVHD. The high IPI mortality rate, both early and late post-transplantation, requires preventive approaches, mainly effective immunization. (Less)
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Contribution to journal
publication status
published
subject
keywords
pneumonia, bacteraemia, Streptococcus pneumoniae, stem cell transplantation, graft-versus-host disease
in
British Journal of Haematology
volume
117
issue
2
pages
444 - 450
publisher
Federation of European Neuroscience Societies and Blackwell Publishing Ltd
external identifiers
  • pmid:11972532
  • wos:000175251400028
  • scopus:0036248164
ISSN
0007-1048
DOI
10.1046/j.1365-2141.2002.03457.x
language
English
LU publication?
yes
id
d7530d6d-e891-4c2e-bd8a-96b02327cad4 (old id 339671)
date added to LUP
2007-08-17 08:37:56
date last changed
2017-11-19 03:30:24
@article{d7530d6d-e891-4c2e-bd8a-96b02327cad4,
  abstract     = {Streptococcus pneumoniae (S. pneumoniae) may cause severe and lethal infections months and years following stem cell transplantation (SCT). In a prospective survey over a 3.5-year period, we assessed the incidence, risk factors and outcome for invasive pneumococcal infection (IPI) following SCT. Fifty-one episodes of IPI were reported: 43 episodes after bone marrow transplantation (BMT) and 8 after peripheral blood stem cell transplantation (PBSCT); 35 after allogeneic SCT and 16 after autologous SCT. Seven IPI episodes, all bacteraemias, were defined as early, occurring 1-35 d (median 3 d) post transplantation. Forty-four episodes were defined as late (greater than or equal to 100 d post SCT), occurring 4 months to 10 years (median 17 months) post transplantation. The incidences of early and late IPI were 2.03/1000 and 8.63/1000 transplantations respectively (P = 0.001). A higher incidence of late IPI was observed after BMT than after PBSCT (10.99 versus 3.23/1000; P &lt; 0.01) and after allogeneic versus autologous SCT (12.20 versus 4.60/1000; P &lt; 0.01). There was a higher estimated incidence of IPI in allogeneic patients with than in those without graft-versus-host disease (GVHD) (18.85 versus 8.25/1000; P = 0.015). The mortality rate was 20%, including 2/7 of early and 8/44 of late IPI. S. pneumoniae is a rare but important complication during the aplastic phase after SCT. In conclusion, S. pneumoniae is a significant cause of morbidity late post-transplantation, especially in allogeneic patients, and particularly those with GVHD. The high IPI mortality rate, both early and late post-transplantation, requires preventive approaches, mainly effective immunization.},
  author       = {Engelhard, D and Cordonnier, C and Shaw, PJ and Parkalli, T and Guenther, C and Martino, R and Dekker, AW and Prentice, HG and Gustavsson, Anita and Nurnberger, W and Ljungman, P},
  issn         = {0007-1048},
  keyword      = {pneumonia,bacteraemia,Streptococcus pneumoniae,stem cell transplantation,graft-versus-host disease},
  language     = {eng},
  number       = {2},
  pages        = {444--450},
  publisher    = {Federation of European Neuroscience Societies and Blackwell Publishing Ltd},
  series       = {British Journal of Haematology},
  title        = {Early and late invasive pneumococcal infection following stem cell transplantation: a European Bone Marrow Transplantation survey},
  url          = {http://dx.doi.org/10.1046/j.1365-2141.2002.03457.x},
  volume       = {117},
  year         = {2002},
}