Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Public Health, New York, NY, USA.
J Travel Med. 2015 Jan-Feb;22(1):39-47. doi: 10.1111/jtm.12166. Epub 2014 Oct 17.
Stem cell transplantation (SCT) is being increasingly utilized for multiple medical illnesses. However, there is limited knowledge about international travel patterns and travel-related illnesses of stem cell transplant recipients (SCTRs).
An observational cross-sectional study was conducted among 979 SCTRs at Memorial Sloan Kettering Cancer Center using a previously standardized and validated questionnaire. International travel post SCT, pre-travel health advice, exposure risks, and travel-related illnesses were queried.
A total of 516 SCTRs completed the survey (55% response rate); of these, 40% were allogeneic SCTRs. A total of 229 (44.3%) respondents reported international travel outside the United States and Canada post SCT. The international travel incidence was 32% [95% confidence interval CI 28-36] within 2 years after SCT. Using multivariable Cox regression analysis, variables significantly associated with international travel within first 2 years after SCT were history of international travel prior to SCT [hazard ratio (HR) = 5.3, 95% CI 2.3-12.0], autologous SCT (HR = 2.6, 95% CI 1.6-2.8), foreign birth (HR = 2.3, 95% CI 1.5-3.3), and high income (HR = 2.0, 95% CI 1.8-3.7). During their first trip, 64 travelers (28%) had traveled to destinations that may have required vaccination or malaria chemoprophylaxis. Only 56% reported seeking pre-travel health advice. Of those who traveled, 16 travelers (7%) became ill enough to require medical attention during their first trip after SCT. Ill travelers were more likely to have visited high-risk areas (60 vs 26%, p = 0.005), to have had a longer mean trip duration (24 vs 12 days, p = 0.0002), and to have visited friends and relatives (69 vs 21%, p < 0.0001).
International travel was common among SCTRs within 2 years after SCT and was mainly to low-risk destinations. Although the overall incidence of travel-related illnesses was low, certain subgroups of travelers were at a significantly higher risk. Pre-travel health counseling and interventions were suboptimal.
干细胞移植（SCT）越来越多地用于多种医疗疾病。然而，对于干细胞移植受者（SCTR）的国际旅行模式和与旅行相关的疾病知之甚少。
对 Memorial Sloan Kettering 癌症中心的 979 名 SCTR 进行了一项观察性横断面研究，使用了先前标准化和验证的问卷。询问了 SCT 后的国际旅行、旅行前的健康建议、暴露风险和与旅行相关的疾病。
共有 516 名 SCTR 完成了调查（55%的应答率）；其中 40%为异基因 SCTR。共有 229 名（44.3%）受访者报告在 SCT 后到美国和加拿大以外的国家进行国际旅行。SCT 后 2 年内国际旅行的发生率为 32%[95%置信区间（CI）28-36]。使用多变量 Cox 回归分析，与 SCT 后 2 年内国际旅行显著相关的变量是 SCT 前的国际旅行史[风险比（HR）=5.3，95%CI 2.3-12.0]、自体 SCT（HR=2.6，95%CI 1.6-2.8）、外国出生（HR=2.3，95%CI 1.5-3.3）和高收入（HR=2.0，95%CI 1.8-3.7）。在他们的第一次旅行中，64 名旅行者（28%）前往可能需要接种疫苗或疟疾化学预防的目的地。只有 56%的人报告寻求旅行前的健康建议。在旅行的人中，有 16 名旅行者（7%）在 SCT 后第一次旅行时病得足以需要医疗照顾。生病的旅行者更有可能前往高风险地区（60%对 26%，p=0.005），旅行时间更长（24 天对 12 天，p=0.0002），并拜访朋友和亲戚（69%对 21%，p<0.0001）。
SCT 后 2 年内，SCTR 中常见国际旅行，主要前往低风险目的地。尽管与旅行相关的疾病总体发生率较低，但某些旅行者亚组的风险明显更高。旅行前的健康咨询和干预措施并不理想。
