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Invasive Pneumococcal Disease After Hematopoietic Cell Transplantation for Sickle Cell Disease

Diego R Hijano1,2, Caitlin Elgarten3, Elizabeth Stenge4

  • 1Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.

Transplant Infectious Disease : an Official Journal of the Transplantation Society
|July 7, 2026
PubMed

Insights

Invasive pneumococcal disease (IPD) is uncommon but severe in children with sickle cell disease (SCD) post-hematopoietic cell transplant (HCT). Infections can occur up to a year after HCT, highlighting the need for ongoing monitoring and vaccination strategies.

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.
Abstract

Keywords:
Streptococcus pneumoniaehematopoietic cell transplantationinvasive pneumococcal diseasepediatric infectionpneumococcal vaccinationsickle cell diseasetransplantation

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