Methods: All adults who underwent UCBT between 1/1/06 and 1/1/16 at our 2 centers were included. Infectious episodes within 6 months before & up to 2 years after UCBT were reviewed.
Results: 57 pt underwent UCBT. Mean age was 43±14 years, & 34 pt were women. 39 (60%) had acute leukemia. Only 47 pt had neutrophil engraftment. 179 infectious episodes occurred in 55 pt, 73 (41%) within 30 days (d) post UCBT. Viruses caused 85 (47%) infections. HHV-6 occurred in 28 episodes, 24 of which were viremia alone, & was most common within 30 d of UCBT. One pt died of HHV-6 encephalitis. CMV caused 32 infectious episodes, 24 of which were viremia only, was most common from d 30-100, & caused no deaths. BK viruria occurred in 18 episodes. Bacteria were responsible for 82 (46%) infections; most common were bacteremias due to Staphylococcus, van-R Enterococcus & Enterobacteriaceae. 3 pt had mycobacterial infections, 2 of which were fatal. Of 11 invasive fungal infections (IFI), 9 were invasive aspergillosis, of which 4 were fatal. Overall mortality was 56% in the 1st year, including 13 deaths from infection. Eleven of these 13 infections occurred in the first 100 d post-UCBT & 7 of them in the first 30 d. Pt who died within 100 d were significantly more likely to have had IFI (p=.04) or infection with VRE (p=.03) or Enterobacteriaceae (p=.03) within 30 d after UCBT. Among the 10 pt who never had neutrophil engraftment, 9 died within 100 d post-UCBT, 6 from infection.
Conclusion: Infectious complications were common after UCBT, especially in the first 30 d. Deaths from viral infections were fewer than expected, most likely because of increased screening & prophylaxis for CMV infections. Delayed engraftment and non-engraftment continue to convey increased risk for fatal bacterial & fungal infections post-UCBT.
K. A. Linder,
C. A. Kauffman, None
S. G. Revankar, None
P. H. Chandrasekar, None
M. H. Miceli, None
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