INFECTIONS IN POLISH PEDIATRIC HEMATOLOGY, ONCOLOGY AND STEM CELL TRANSPLANTATION CENTERS IN 2012-2013: INCIDENCE REPORT
DOI:
https://doi.org/10.12775/MBS.2014.017Keywords
bacterial infections, invasive fungal infections, viral infections, malignant diseases, oncohematology, hematopoietic stem cell transplantation, childrenAbstract
B a c k g r o u n d . Infections are the main cause of morbidity and mortality in children with cancer or undergoing stem cell transplantation. O b j e c t i v e . The aim of this study was the analysis of incidence and outcome of bacterial, fungal and viral infections in Polish centers of pediatric hematology and oncology (PHO) and pediatric hematopoietic stem cell transplantation (HSCT) units over a period of 24 months: iPhot-13 project. P a t i e n t s a n d m e t h o d s . During the analyzed period a total number of 1768 patients were newly-diagnosed for malignancy and 308 HSCTs were performed in participating centers. A total number of 2556 infections were reported. R e s u l t s . The incidence of patients with at least one episode of microbiologically documented infections with bacteria etiology was 26.3% among children undergoing chemo- and/or radiotherapy, and 34.1% among children undergoing hematopoietic stem cell transplantation. The incidence of patients with at least one episode of fungal infection was 7.6% among children undergoing chemoand/ or radiotherapy, and 27.3% among children undergoing hematopoietic stem cell transplantation. The incidence of IFI was prominently high in ALL (13.0% in PHO setting, and 31.3% in HSCT setting) and AML patients (43.2% in PHO, and 44.7% in HSCT setting). Viral infections reached 9.3% of patients in PHO setting, including a group of previously transplanted patients. The incidence of viral infections in HSCT setting reached 41.2%. This rate reached 51.3% children after allo-HSCT and 10.5% after auto-HSCT. C o n c l u s i o n s . Emerging data from Polish pediatric oncohematology and hematopoietic stem cell transplant centers indicate high incidence of infectious complications in pediatric population. Rate of bacterial infections is similar to those reported in international studies. The incidence of IFI in ALL and AML is much higher than it was recently anticipated. Viral infections occur in half of transplant patients and might severely compromise the benefit of transplant.
References
Gooley TA, Chien JW, Pergam SA, Hingorani S, Sorror ML, Boeckh M, Martin PJ, Sandmaier BM, Marr KA,
Appelbaum FR, Storb R, McDonald GB: Reduced mortality after allogeneic hematopoietic-cell transplantation. N Engl J Med 2010;363:2091-2101. DOI: http://dx.doi.org/10.1056/NEJMoa1004383
Styczynski J, Gil L: Prevention of infectious complications in pediatric HSCT. Bone Marrow Transplant 2008;42 Suppl 2:S77-81.
Mikulska M, Del Bono V, Raiola AM, Bruno B, Gualandi F, Occhini D, di Grazia C, Frassoni F, Bacigalupo A, Viscoli C: Blood stream infections in allogeneic hematopoietic stem cell transplant recipients: Reemergence of Gram-negative rods and increasing antibiotic resistance. Biol Blood Marrow Transplant 2009;15:47-53.
Caselli D, Cesaro S, Ziino O, Zanazzo G, Manicone R, Livadiotti S, Cellini M, Frenos S, Milano GM, Cappelli B, Licciardello M, Beretta C, Arico M, Castagnola E: Multidrug resistant Pseudomonas aeruginosa infection in children undergoing chemotherapy and hematopoietic stem cell transplantation. Haematologica 2010;95:1612-1615. DOI: http://dx.doi.org/10.3324/haematol.2009.020867
Gil L, Styczynski J, Komarnicki M: Infectious complication in 314 patients after high-dose therapy and autologous hematopoietic stem cell transplantation: Risk factors analysis and outcome. Infection 2007;35:421-427.
Groll AH, Castagnola E, Cesaro S, Dalle JH, Engelhard D, Hope W, Roilides E, Styczynski J, Warris A, Lehrnbecher T: Fourth European Conference on Infections in Leukaemia (ECIL-4): Guidelines for diagnosis, prevention and treatment of invasive fungal diseases in paediatric patients with cancer or allogeneic haematopoietic stem cell transplantation. Lancet Oncol 2014;(in press)
Styczynski J: Diagnostyka i leczenie inwazyjnych zakażeń grzybiczych u dzieci: Rekomendacje pediatrycznej grupy ECIL-4. Zakażenia 2012;12:73-82.
Czyżewski K, Styczynski J, Krenska A, Debski R, Zajac- Spychala O, Wachowiak J, Wysocki M: Intrathecal therapy with rituximab in central nervous system involvement of post-transplant lymphoproliferative disorder. Leuk Lymphoma 2013;54:503-506.
Styczynski J, Gil L, Tridello G, Ljungman P, Donnelly JP, van der Velden W, Omar H, Martino R, Halkes C, Faraci M, Theunissen K, Kalwak K, Hubacek P, Sica S, Nozzoli C, Fagioli F, Matthes S, Diaz MA, Migliavacca M, Balduzzi A, Tomaszewska A, Camara Rde L, van Biezen A, Hoek J, Iacobelli S, Einsele H, Cesaro S: Response to rituximab-based therapy and risk factor analysis in epstein barr virus-related lymphoproliferative disorder after hematopoietic stem cell transplant in children and adults: A study from the Infectious Diseases Working Party of the European group for Blood and Marrow Transplantation. Clin Infect Dis 2013;57:794-802.
Styczynski J, Reusser P, Einsele H, de la Camara R, Cordonnier C, Ward KN, Ljungman P, Engelhard D: Management of HSV, VZV and EBV infections in patients with hematological malignancies and after sct: Guidelines from the second European Conference on Infections in Leukemia. Bone Marrow Transplant 2009;43:757-770.
Zaia J, Baden L, Boeckh MJ, Chakrabarti S, Einsele H, Ljungman P, McDonald GB, Hirsch H: Viral disease prevention after hematopoietic cell transplantation. Bone Marrow Transplant 2009;44:471-482.
Ljungman P, de la Camara R, Cordonnier C, Einsele H, Engelhard D, Reusser P, Styczynski J, Ward K: Management of CMV, HHV-6, HHV-7 and Kaposisarcoma herpesvirus (HHV-8) infections in patients with hematological malignancies and after SCT. Bone Marrow Transplant 2008;42:227-240.
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