Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation

Celalettin Ustun; Jo Anne H. Young; Genovefa A. Papanicolaou; Soyoung Kim; Kwang Woo Ahn; Min Chen; Hisham Abdel-Azim; Mahmoud Aljurf; Amer Beitinjaneh; Valerie Brown; Jan Cerny; Saurabh Chhabra; Mohamed A. Kharfan-Dabaja; Parastoo B. Dahi; Andrew Daly; Christopher E. Dandoy; Christopher C. Dvorak; Cesar O. Freytes; Shahrukh Hashmi; Hillard Lazarus; Per Ljungman; Taiga Nishihori; Kristin Page; Sai R.K. Pingali; Ayman Saad; Bipin N. Savani; Daniel Weisdorf; Kirsten Williams; Baldeep Wirk; Jeffery J. Auletta; Caroline A. Lindemans; Krishna Komanduri; Marcie Riches

doi:10.1038/s41409-018-0401-4

Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation

Celalettin Ustun, Jo Anne H. Young, Genovefa A. Papanicolaou, Soyoung Kim, Kwang Woo Ahn, Min Chen, Hisham Abdel-Azim, Mahmoud Aljurf, Amer Beitinjaneh, Valerie Brown, Jan Cerny, Saurabh Chhabra, Mohamed A. Kharfan-Dabaja, Parastoo B. Dahi, Andrew Daly, Christopher E. Dandoy, Christopher C. Dvorak, Cesar O. Freytes, Shahrukh Hashmi, Hillard LazarusPer Ljungman, Taiga Nishihori, Kristin Page, Sai R.K. Pingali, Ayman Saad, Bipin N. Savani, Daniel Weisdorf, Kirsten Williams, Baldeep Wirk, Jeffery J. Auletta, Caroline A. Lindemans, Krishna Komanduri, Marcie Riches

Research output: Contribution to journal › Article › peer-review

50 Scopus citations

Abstract

We analyzed CIBMTR data to evaluate the incidence of non-relapse mortality (NRM) and association with overall survival (OS) for bacterial blood stream infections (BSIs) occurring within 100 days of alloHCT in 2 different phases: pre-/peri-engraftment (BSI very early phase, BSI-VEP) and BSI post-engraftment (BSI occurring between 2 weeks after engraftment and day 100, late early phase, BSI-LEP). Of the 7128 alloHCT patients, 2656 (37%) had ≥1 BSI by day 100. BSI-VEP, BSI-LEP, and BSI-Both constituted 56% (n = 1492), 31% (n = 824), and 13% (n = 340) of total BSI, respectively. Starting in 2009, we observed a gradual decline in BSI incidence through 2012 (61–48%). Patients with BSI-VEP were more likely to receive a myeloablative conditioning (MAC) regimen with total body irradiation (TBI). NRM was significantly higher in patients with any BSI (RR 1.82 95% CI 1.63–2.04 for BSI-VEP, RR 2.46, 95% CI 2.05–2.96 for BSI-LEP, and RR 2.29, 95% CI 1.87–2.81 for BSI-Both) compared with those without BSI. OS was significantly lower in patients with any BSI compared with patients without BSI (RR 1.36, 95% CI 1.26–1.47 for BSI-VEP; RR 1.83, 95% CI 1.58–2.12 for BSI-LEP: RR 1.66, 95% CI 1.43–1.94 for BSI-Both). BSIs within day 100 after alloHCT are common and remain a risk factor for mortality.

Original language	English (US)
Pages (from-to)	1254-1265
Number of pages	12
Journal	Bone marrow transplantation
Volume	54
Issue number	8
DOIs	https://doi.org/10.1038/s41409-018-0401-4
State	Published - Aug 1 2019

Bibliographical note

Funding Information:
CIBMTR Support List The CIBMTR is supported primarily by Public Health Service Grant/Cooperative Agreement 5U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); a Grant/Cooperative Agreement 4U10HL069294 from NHLBI and NCI; a contract HHSH250201200016C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-17-1-2388 and N0014-17-1-2850 from the Office of Naval Research; and grants from *Actinium Pharmaceuticals, Inc.; *Amgen, Inc.; *Amneal Biosciences; *Angio-crine Bioscience, Inc.; Anonymous donation to the Medical College of Wisconsin; Astellas Pharma US; Atara Biotherapeutics, Inc.; Be the Match Foundation; *bluebird bio, Inc.; *Bristol Myers Squibb Oncology; *Celgene Corporation; Cerus Corporation; *Chimerix, Inc.; Fred Hutchinson Cancer Research Center; Gamida Cell Ltd.; Gilead Sciences, Inc.; HistoGenetics, Inc.; Immucor; *Incyte Corporation; Jans-sen Scientific Affairs, LLC; *Jazz Pharmaceuticals, Inc.; Juno Therapeutics; Karyopharm Therapeutics, Inc.; Kite Pharma, Inc.; Medac, GmbH; MedImmune; The Medical College of Wisconsin; *Mediware; *Merck & Co, Inc.; *Mesoblast; MesoScale Diagnostics, Inc.; Millennium, the Takeda Oncology Co.; *Miltenyi Biotec, Inc.; National Marrow Donor Program; *Neovii Biotech NA, Inc.; Novartis Pharmaceuticals Corporation; Otsuka Pharmaceutical Co, Ltd. – Japan; PCORI; *Pfizer, Inc; *Pharmacyclics, LLC; PIRCHE AG; *Sanofi Genzyme; *Seattle Genetics; Shire; Spectrum Pharmaceuticals, Inc.; St. Baldrick’s Foundation; *Sunesis Pharmaceuticals, Inc.; Swedish Orphan Biovitrum, Inc.; Takeda Oncology; Telomere Diagnostics, Inc.; and University of Minnesota. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration (HRSA) or any other agency of the U.S. Government. *Corporate Members.

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© 2018, Springer Nature Limited.

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Ustun, C., Young, J. A. H., Papanicolaou, G. A., Kim, S., Ahn, K. W., Chen, M., Abdel-Azim, H., Aljurf, M., Beitinjaneh, A., Brown, V., Cerny, J., Chhabra, S., Kharfan-Dabaja, M. A., Dahi, P. B., Daly, A., Dandoy, C. E., Dvorak, C. C., Freytes, C. O., Hashmi, S., ... Riches, M. (2019). Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation. Bone marrow transplantation, 54(8), 1254-1265. https://doi.org/10.1038/s41409-018-0401-4

Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation. / Ustun, Celalettin; Young, Jo Anne H.; Papanicolaou, Genovefa A. et al.
In: Bone marrow transplantation, Vol. 54, No. 8, 01.08.2019, p. 1254-1265.

Research output: Contribution to journal › Article › peer-review

Ustun, C, Young, JAH, Papanicolaou, GA, Kim, S, Ahn, KW, Chen, M, Abdel-Azim, H, Aljurf, M, Beitinjaneh, A, Brown, V, Cerny, J, Chhabra, S, Kharfan-Dabaja, MA, Dahi, PB, Daly, A, Dandoy, CE, Dvorak, CC, Freytes, CO, Hashmi, S, Lazarus, H, Ljungman, P, Nishihori, T, Page, K, Pingali, SRK, Saad, A, Savani, BN, Weisdorf, D, Williams, K, Wirk, B, Auletta, JJ, Lindemans, CA, Komanduri, K & Riches, M 2019, 'Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation', Bone marrow transplantation, vol. 54, no. 8, pp. 1254-1265. https://doi.org/10.1038/s41409-018-0401-4

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title = "Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation",

abstract = "We analyzed CIBMTR data to evaluate the incidence of non-relapse mortality (NRM) and association with overall survival (OS) for bacterial blood stream infections (BSIs) occurring within 100 days of alloHCT in 2 different phases: pre-/peri-engraftment (BSI very early phase, BSI-VEP) and BSI post-engraftment (BSI occurring between 2 weeks after engraftment and day 100, late early phase, BSI-LEP). Of the 7128 alloHCT patients, 2656 (37%) had ≥1 BSI by day 100. BSI-VEP, BSI-LEP, and BSI-Both constituted 56% (n = 1492), 31% (n = 824), and 13% (n = 340) of total BSI, respectively. Starting in 2009, we observed a gradual decline in BSI incidence through 2012 (61–48%). Patients with BSI-VEP were more likely to receive a myeloablative conditioning (MAC) regimen with total body irradiation (TBI). NRM was significantly higher in patients with any BSI (RR 1.82 95% CI 1.63–2.04 for BSI-VEP, RR 2.46, 95% CI 2.05–2.96 for BSI-LEP, and RR 2.29, 95% CI 1.87–2.81 for BSI-Both) compared with those without BSI. OS was significantly lower in patients with any BSI compared with patients without BSI (RR 1.36, 95% CI 1.26–1.47 for BSI-VEP; RR 1.83, 95% CI 1.58–2.12 for BSI-LEP: RR 1.66, 95% CI 1.43–1.94 for BSI-Both). BSIs within day 100 after alloHCT are common and remain a risk factor for mortality.",

author = "Celalettin Ustun and Young, {Jo Anne H.} and Papanicolaou, {Genovefa A.} and Soyoung Kim and Ahn, {Kwang Woo} and Min Chen and Hisham Abdel-Azim and Mahmoud Aljurf and Amer Beitinjaneh and Valerie Brown and Jan Cerny and Saurabh Chhabra and Kharfan-Dabaja, {Mohamed A.} and Dahi, {Parastoo B.} and Andrew Daly and Dandoy, {Christopher E.} and Dvorak, {Christopher C.} and Freytes, {Cesar O.} and Shahrukh Hashmi and Hillard Lazarus and Per Ljungman and Taiga Nishihori and Kristin Page and Pingali, {Sai R.K.} and Ayman Saad and Savani, {Bipin N.} and Daniel Weisdorf and Kirsten Williams and Baldeep Wirk and Auletta, {Jeffery J.} and Lindemans, {Caroline A.} and Krishna Komanduri and Marcie Riches",

note = "Funding Information: CIBMTR Support List The CIBMTR is supported primarily by Public Health Service Grant/Cooperative Agreement 5U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); a Grant/Cooperative Agreement 4U10HL069294 from NHLBI and NCI; a contract HHSH250201200016C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-17-1-2388 and N0014-17-1-2850 from the Office of Naval Research; and grants from *Actinium Pharmaceuticals, Inc.; *Amgen, Inc.; *Amneal Biosciences; *Angio-crine Bioscience, Inc.; Anonymous donation to the Medical College of Wisconsin; Astellas Pharma US; Atara Biotherapeutics, Inc.; Be the Match Foundation; *bluebird bio, Inc.; *Bristol Myers Squibb Oncology; *Celgene Corporation; Cerus Corporation; *Chimerix, Inc.; Fred Hutchinson Cancer Research Center; Gamida Cell Ltd.; Gilead Sciences, Inc.; HistoGenetics, Inc.; Immucor; *Incyte Corporation; Jans-sen Scientific Affairs, LLC; *Jazz Pharmaceuticals, Inc.; Juno Therapeutics; Karyopharm Therapeutics, Inc.; Kite Pharma, Inc.; Medac, GmbH; MedImmune; The Medical College of Wisconsin; *Mediware; *Merck & Co, Inc.; *Mesoblast; MesoScale Diagnostics, Inc.; Millennium, the Takeda Oncology Co.; *Miltenyi Biotec, Inc.; National Marrow Donor Program; *Neovii Biotech NA, Inc.; Novartis Pharmaceuticals Corporation; Otsuka Pharmaceutical Co, Ltd. – Japan; PCORI; *Pfizer, Inc; *Pharmacyclics, LLC; PIRCHE AG; *Sanofi Genzyme; *Seattle Genetics; Shire; Spectrum Pharmaceuticals, Inc.; St. Baldrick{\textquoteright}s Foundation; *Sunesis Pharmaceuticals, Inc.; Swedish Orphan Biovitrum, Inc.; Takeda Oncology; Telomere Diagnostics, Inc.; and University of Minnesota. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration (HRSA) or any other agency of the U.S. Government. *Corporate Members. Publisher Copyright: {\textcopyright} 2018, Springer Nature Limited.",

year = "2019",

month = aug,

day = "1",

doi = "10.1038/s41409-018-0401-4",

language = "English (US)",

volume = "54",

pages = "1254--1265",

journal = "Bone marrow transplantation",

issn = "0268-3369",

publisher = "Nature Publishing Group",

number = "8",

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TY - JOUR

T1 - Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation

AU - Ustun, Celalettin

AU - Young, Jo Anne H.

AU - Papanicolaou, Genovefa A.

AU - Kim, Soyoung

AU - Ahn, Kwang Woo

AU - Chen, Min

AU - Abdel-Azim, Hisham

AU - Aljurf, Mahmoud

AU - Beitinjaneh, Amer

AU - Brown, Valerie

AU - Cerny, Jan

AU - Chhabra, Saurabh

AU - Kharfan-Dabaja, Mohamed A.

AU - Dahi, Parastoo B.

AU - Daly, Andrew

AU - Dandoy, Christopher E.

AU - Dvorak, Christopher C.

AU - Freytes, Cesar O.

AU - Hashmi, Shahrukh

AU - Lazarus, Hillard

AU - Ljungman, Per

AU - Nishihori, Taiga

AU - Page, Kristin

AU - Pingali, Sai R.K.

AU - Saad, Ayman

AU - Savani, Bipin N.

AU - Weisdorf, Daniel

AU - Williams, Kirsten

AU - Wirk, Baldeep

AU - Auletta, Jeffery J.

AU - Lindemans, Caroline A.

AU - Komanduri, Krishna

AU - Riches, Marcie

N1 - Funding Information: CIBMTR Support List The CIBMTR is supported primarily by Public Health Service Grant/Cooperative Agreement 5U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); a Grant/Cooperative Agreement 4U10HL069294 from NHLBI and NCI; a contract HHSH250201200016C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-17-1-2388 and N0014-17-1-2850 from the Office of Naval Research; and grants from *Actinium Pharmaceuticals, Inc.; *Amgen, Inc.; *Amneal Biosciences; *Angio-crine Bioscience, Inc.; Anonymous donation to the Medical College of Wisconsin; Astellas Pharma US; Atara Biotherapeutics, Inc.; Be the Match Foundation; *bluebird bio, Inc.; *Bristol Myers Squibb Oncology; *Celgene Corporation; Cerus Corporation; *Chimerix, Inc.; Fred Hutchinson Cancer Research Center; Gamida Cell Ltd.; Gilead Sciences, Inc.; HistoGenetics, Inc.; Immucor; *Incyte Corporation; Jans-sen Scientific Affairs, LLC; *Jazz Pharmaceuticals, Inc.; Juno Therapeutics; Karyopharm Therapeutics, Inc.; Kite Pharma, Inc.; Medac, GmbH; MedImmune; The Medical College of Wisconsin; *Mediware; *Merck & Co, Inc.; *Mesoblast; MesoScale Diagnostics, Inc.; Millennium, the Takeda Oncology Co.; *Miltenyi Biotec, Inc.; National Marrow Donor Program; *Neovii Biotech NA, Inc.; Novartis Pharmaceuticals Corporation; Otsuka Pharmaceutical Co, Ltd. – Japan; PCORI; *Pfizer, Inc; *Pharmacyclics, LLC; PIRCHE AG; *Sanofi Genzyme; *Seattle Genetics; Shire; Spectrum Pharmaceuticals, Inc.; St. Baldrick’s Foundation; *Sunesis Pharmaceuticals, Inc.; Swedish Orphan Biovitrum, Inc.; Takeda Oncology; Telomere Diagnostics, Inc.; and University of Minnesota. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration (HRSA) or any other agency of the U.S. Government. *Corporate Members. Publisher Copyright: © 2018, Springer Nature Limited.

PY - 2019/8/1

Y1 - 2019/8/1

N2 - We analyzed CIBMTR data to evaluate the incidence of non-relapse mortality (NRM) and association with overall survival (OS) for bacterial blood stream infections (BSIs) occurring within 100 days of alloHCT in 2 different phases: pre-/peri-engraftment (BSI very early phase, BSI-VEP) and BSI post-engraftment (BSI occurring between 2 weeks after engraftment and day 100, late early phase, BSI-LEP). Of the 7128 alloHCT patients, 2656 (37%) had ≥1 BSI by day 100. BSI-VEP, BSI-LEP, and BSI-Both constituted 56% (n = 1492), 31% (n = 824), and 13% (n = 340) of total BSI, respectively. Starting in 2009, we observed a gradual decline in BSI incidence through 2012 (61–48%). Patients with BSI-VEP were more likely to receive a myeloablative conditioning (MAC) regimen with total body irradiation (TBI). NRM was significantly higher in patients with any BSI (RR 1.82 95% CI 1.63–2.04 for BSI-VEP, RR 2.46, 95% CI 2.05–2.96 for BSI-LEP, and RR 2.29, 95% CI 1.87–2.81 for BSI-Both) compared with those without BSI. OS was significantly lower in patients with any BSI compared with patients without BSI (RR 1.36, 95% CI 1.26–1.47 for BSI-VEP; RR 1.83, 95% CI 1.58–2.12 for BSI-LEP: RR 1.66, 95% CI 1.43–1.94 for BSI-Both). BSIs within day 100 after alloHCT are common and remain a risk factor for mortality.

AB - We analyzed CIBMTR data to evaluate the incidence of non-relapse mortality (NRM) and association with overall survival (OS) for bacterial blood stream infections (BSIs) occurring within 100 days of alloHCT in 2 different phases: pre-/peri-engraftment (BSI very early phase, BSI-VEP) and BSI post-engraftment (BSI occurring between 2 weeks after engraftment and day 100, late early phase, BSI-LEP). Of the 7128 alloHCT patients, 2656 (37%) had ≥1 BSI by day 100. BSI-VEP, BSI-LEP, and BSI-Both constituted 56% (n = 1492), 31% (n = 824), and 13% (n = 340) of total BSI, respectively. Starting in 2009, we observed a gradual decline in BSI incidence through 2012 (61–48%). Patients with BSI-VEP were more likely to receive a myeloablative conditioning (MAC) regimen with total body irradiation (TBI). NRM was significantly higher in patients with any BSI (RR 1.82 95% CI 1.63–2.04 for BSI-VEP, RR 2.46, 95% CI 2.05–2.96 for BSI-LEP, and RR 2.29, 95% CI 1.87–2.81 for BSI-Both) compared with those without BSI. OS was significantly lower in patients with any BSI compared with patients without BSI (RR 1.36, 95% CI 1.26–1.47 for BSI-VEP; RR 1.83, 95% CI 1.58–2.12 for BSI-LEP: RR 1.66, 95% CI 1.43–1.94 for BSI-Both). BSIs within day 100 after alloHCT are common and remain a risk factor for mortality.

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UR - http://www.scopus.com/inward/citedby.url?scp=85058447470&partnerID=8YFLogxK

U2 - 10.1038/s41409-018-0401-4

DO - 10.1038/s41409-018-0401-4

M3 - Article

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AN - SCOPUS:85058447470

SN - 0268-3369

VL - 54

SP - 1254

EP - 1265

JO - Bone marrow transplantation

JF - Bone marrow transplantation

IS - 8

ER -

Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation

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