Zaucha-Prażmo A, Kowalczyk J R, Drabko K, Czyżewski K, Goździk J, Zając-Spychała O, Wachowiak J, Frączkiewicz J, Gorczyńska E, Kałwak K, Styczyński J
Department of Pediatric Hematology, Oncology and Transplantology, Medical University, Lublin, University Children Hospital, Lublin, Poland.
Department of Pediatric Hematology, Oncology and Transplantology, Medical University, Lublin, University Children Hospital, Lublin, Poland.
Transplant Proc. 2017 Nov;49(9):2183-2187. doi: 10.1016/j.transproceed.2017.09.027.
We analyzed incidence and profile of infections in children with acute lymphoblastic leukemia (ALL) treated with hematopoietic stem cell transplantation (HSCT) in Polish pediatric HSCT departments, over a 2-year period.
Hospital records of 67 patients, who underwent allogeneic HSCT for ALL, were analyzed retrospectively for microbiologically documented infection: bacterial infection (BI), viral infection (VI), and fungal infection (FI). The majority of patients (40/67; 59.7%) underwent HSCT from matched unrelated donors (MUD).
In total, 84 BI in 31 patients, 93 VI in 50 patients, and 27 FI in 22 patients were diagnosed. No differences were found in the frequency of occurrence of BI according to the type of transplant (P = .16); the occurrence of VI was statistically more frequent in MUD transplant recipients as compared with matched sibling donors (MSD) and mismatched related donors (MMFD; P = .001) and there was a trend in MUD patients for the higher occurrence of FI in comparison with MSD and MMFD transplants (P = .08). Regarding disease status, the occurrence of BI, VI, and FI was statistically more frequent in children who underwent transplantation in their first complete remission (CR1), rather than those who underwent transplantation in ≥CR2 (P < .05). In conclusion, infectious complications are an important cause of morbidity in children with ALL treated with allogeneic HSCT and the incidence of infections is high in this group of patients.
我们分析了波兰儿科造血干细胞移植（HSCT）科室中，接受造血干细胞移植治疗的急性淋巴细胞白血病（ALL）患儿在两年期间的感染发生率及感染情况。
回顾性分析67例接受异基因HSCT治疗ALL的患者的医院记录，以获取微生物学确诊的感染情况：细菌感染（BI）、病毒感染（VI）和真菌感染（FI）。大多数患者（40/67；59.7%）接受了来自匹配无关供者（MUD）的HSCT。
共诊断出31例患者发生84次细菌感染，50例患者发生93次病毒感染，22例患者发生27次真菌感染。根据移植类型，细菌感染的发生频率无差异（P = 0.16）；与匹配同胞供者（MSD）和不匹配相关供者（MMFD）相比，MUD移植受者中病毒感染的发生在统计学上更频繁（P = 0.001），并且与MSD和MMFD移植相比，MUD患者中真菌感染的发生有更高的趋势（P = 0.08）。关于疾病状态，首次完全缓解（CR1）时接受移植的儿童中，细菌感染、病毒感染和真菌感染的发生在统计学上比在≥CR2时接受移植的儿童更频繁（P < 0.05）。总之，感染并发症是接受异基因HSCT治疗的ALL患儿发病的重要原因，该组患者的感染发生率很高。
