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Generation of Multivirus-specific T Cells to Prevent/treat Viral Infections after Allogeneic Hematopoietic Stem Cell Transplant
Published on: May 27, 2011
Central nervous system infection following allogeneic hematopoietic stem cell transplantation
Ryo Hanajiri1, Takeshi Kobayashi1, Kosuke Yoshioka1
1Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Insights
Central nervous system (CNS) infections after allogeneic hematopoietic stem cell transplantation (allo-HSCT) are serious complications. High-risk disease status increases CNS infection risk, impacting overall survival rates post-transplant.
Area of Science:
- Hematology
- Infectious Diseases
- Transplantation Immunology
Background:
- Central nervous system (CNS) infections are a significant concern following allogeneic hematopoietic stem cell transplantation (allo-HSCT).
- Understanding the clinical characteristics and outcomes of these infections is crucial for improving patient management.
Purpose of the Study:
- To describe the clinical features and outcomes of CNS infections in patients undergoing allo-HSCT.
- To identify risk factors associated with CNS infection development and its impact on survival.
Main Methods:
- Retrospective review of charts from 353 consecutive allo-HSCT recipients.
- Analysis of CNS infection cases, including causative pathogens and incidence rates.
Main Results:
- 17 CNS infections were identified at a median of 38 days post-allo-HSCT.
- Common pathogens included human herpesvirus-6, enterococcus, and staphylococcus.
- Cumulative incidence of CNS infection was 4.1% at 1 year and 5.5% at 5 years.
Conclusions:
- High-risk disease status is a significant risk factor for CNS infection post-allo-HSCT.
- Patients with CNS infection had lower overall survival (33%) compared to those without (53%) at 3 years post-transplant.
Objective/Background:
Here, we described the clinical characteristics and outcomes of central nervous system (CNS) infections occurring after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in a single institution over the previous 6 years.
Methods:
Charts of 353 consecutive allogeneic transplant recipients were retrospectively reviewed for CNS infection.
Results:
A total of 17 cases of CNS infection were identified at a median of 38 days (range, 10-1028 days) after allo-HSCT. Causative pathogens were human herpesvirus-6 (n=6), enterococcus (n=2), staphylococcus (n=2), streptococcus (n=2), varicella zoster virus (n=1), cytomegalovirus (n=1), John Cunningham virus (n=1), adenovirus (n=1), and Toxoplasma gondii (n=1). The cumulative incidence of CNS infection was 4.1% at 1 year and 5.5% at 5 years.
Conclusion:
Multivariate analysis revealed that high-risk disease status was a risk factor for developing CNS infection (p=.02), and that overall survival at 3 years after allo-HSCT was 33% in patients with CNS infection and 53% in those without CNS infection (p=.04).
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