Invasive Pneumococcal Disease After Hematopoietic Cell Transplantation for Sickle Cell Disease

Area of Science:

• Hematology
• Infectious Diseases
• Pediatrics

Background:

• Children with sickle cell disease (SCD) have impaired splenic function, increasing their risk of invasive pneumococcal disease (IPD).
• Data on IPD following allogeneic hematopoietic cell transplantation (HCT) for SCD are scarce.

Purpose of the Study:

• To investigate the incidence and clinical characteristics of IPD in children and young adults with SCD after allogeneic HCT.
• To assess the timing and severity of IPD in this vulnerable population.

Main Methods:

• A multicenter retrospective cohort study was conducted involving children and young adults with SCD.
• Patients underwent first allogeneic HCT at two STAR centers.
• IPD cases within 365 days post-HCT were identified via registry data, microbiologic review, and chart review.

Main Results:

• Three out of 182 patients developed IPD within one year post-HCT.
• All IPD cases presented with sepsis and bacteremia; one also had meningitis and died.
• Infections occurred between 7 and 365 days post-HCT; no patients had received pneumococcal vaccination prior to diagnosis.

Conclusions:

• IPD is uncommon but severe in SCD patients undergoing allogeneic HCT, with late-onset infections possible.
• Further prospective research is needed on immune recovery, splenic function, vaccination, and long-term outcomes.
• Better strategies are required to address persistent susceptibility to IPD after HCT in SCD patients.