The incidence and impact of clostridioides difficile infection on transplant outcomes in acute leukemia and MDS after allogeneic hematopoietic cell transplant - A CIBMTR study Journal Article
| Authors: | Ramanathan, M.; Kim, S.; He, N.; Chen, M.; Hematti, P.; Abid, M. B.; Rotz, S. J.; Williams, K. M.; Lazarus, H. M.; Wirk, B.; Yin, D. E.; Kanakry, C. G.; Perales, M. A.; Chemaly, R. F.; Dandoy, C. E.; Riches, M.; Ustun, C. |
| Article Title: | The incidence and impact of clostridioides difficile infection on transplant outcomes in acute leukemia and MDS after allogeneic hematopoietic cell transplant - A CIBMTR study |
| Abstract: | Clostridioides difficile infection (CDI) is common after allogeneic hematopoietic cell transplantation (alloHCT). The determination of incidence, risk factors, and impact of CDI on alloHCT outcomes is an unmet need. The study examines all patients aged 2 years and older who received first alloHCT for acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), or myelodysplastic syndrome (MDS) between 2013 and 2018 at US centers and reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) data registry. In total, 826 patients with CDI and 6723 controls from 127 centers were analyzed. The cumulative incidence of CDI by day 100 was 18.7% (99% CI: 15–22.7%) and 10.2% (99% CI: 9.2–11.1%) in pediatric and adult patients, respectively, with a median time to diagnosis at day +13. CDI was associated with inferior overall survival (OS) (p = 0.0018) and a 2.58-fold [99% CI: 1.43–4.66; p < 0.001] increase in infection-related mortality (IRM). There was a significant overlap in the onset of acute graft versus host disease (aGVHD) and CDI. IRM increased to >4 fold when CDI + aGVHD was considered. Despite advances in the management of CDI, increased IRM and decreased OS still results from CDI. © 2022, The Author(s), under exclusive licence to Springer Nature Limited. |
| Keywords: | adolescent; adult; child; controlled study; retrospective studies; transplantation, homologous; major clinical study; overall survival; leukemia, myeloid, acute; mortality; treatment duration; united states; outcome assessment; cancer diagnosis; incidence; cohort analysis; hematopoietic stem cell transplantation; retrospective study; acute lymphoblastic leukemia; age; patient care; acute graft versus host disease; acute leukemia; myelodysplastic syndrome; graft versus host reaction; allogeneic hematopoietic stem cell transplantation; clostridium difficile infection; observational study; graft vs host disease; allotransplantation; myelodysplastic syndromes; clostridium infection; clostridium infections; adverse event; complication; acute myeloid leukemia; humans; human; male; female; article |
| Journal Title: | Bone Marrow Transplantation |
| Volume: | 58 |
| Issue: | 4 |
| ISSN: | 0268-3369 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2023-04-01 |
| Start Page: | 360 |
| End Page: | 366 |
| Language: | English |
| DOI: | 10.1038/s41409-022-01896-z |
| PUBMED: | 36543999 |
| PROVIDER: | scopus |
| PMCID: | PMC10079570 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 May 2023 -- Source: Scopus |
