Early bacterial and fungal infection in children receiving allogeneic stem cell transplantation for acute lymphoblastic leukemia in Argentina

Pediatr Transplant. 2018 Feb;22(1). doi: 10.1111/petr.13070. Epub 2017 Oct 29.

Abstract

Infections are important complications associated with allogeneic HSCT. Describing infection rates in low- and middle-income countries provides data to infer efficacy of supportive care practices in these settings. In this retrospective cohort study, we included patients (age ≤ 18 years) who underwent a first allogeneic HSCT for ALL in a single center in Argentina between 1998 and 2016. The primary outcome was sterile site bacterial infection. Secondary outcomes were proven or probable invasive fungal infection, TRM, and infectious deaths. There were 68 allogeneic HSCT recipients with ALL included in this analysis. Overall, 17 (25.0%) experienced at least one sterile site bacterial infection and 10 (14.7%) experienced at least one proven or probable invasive fungal infection. The TRM rate was 19.1%, and 3 (4.4%) patients died of infection. In a middle-income country center in Argentina, pediatric allogeneic HSCT infection rates, TRM, and infection-related mortality were comparable to high-income countries. These data support continuation of allogeneic HSCT programs in similar resource-limited settings provided that adequate supportive care and monitoring of outcomes can be performed.

Keywords: fungal infection; hematopoietic stem cell transplantation; infectious risk; pediatric.

MeSH terms

  • Adolescent
  • Argentina
  • Aspergillosis / diagnosis
  • Aspergillosis / epidemiology
  • Aspergillosis / etiology*
  • Candidiasis / diagnosis
  • Candidiasis / epidemiology
  • Candidiasis / etiology*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Negative Bacterial Infections / epidemiology
  • Gram-Negative Bacterial Infections / etiology*
  • Gram-Positive Bacterial Infections / diagnosis
  • Gram-Positive Bacterial Infections / epidemiology
  • Gram-Positive Bacterial Infections / etiology*
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Retrospective Studies
  • Transplantation, Homologous
  • Treatment Outcome