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Incidence, risk factors, and mortality from pneumonia developing late after hematopoietic stem cell transplantation.

Publication ,  Journal Article
Chen, C-S; Boeckh, M; Seidel, K; Clark, JG; Kansu, E; Madtes, DK; Wagner, JL; Witherspoon, RP; Anasetti, C; Appelbaum, FR; Bensinger, WI ...
Published in: Bone Marrow Transplant
September 2003

The incidence, etiology, outcome, and risk factors for developing pneumonia late after hematopoietic stem cell transplantation (SCT) were investigated in 1359 patients transplanted in Seattle. A total of 341 patients (25% of the cohort) developed at least one pneumonic episode. No microbial or tissue diagnosis (ie clinical pneumonia) was established in 197 patients (58% of first pneumonia cases). Among the remaining 144 patients, established etiologies included 33 viral (10%), 31 bacterial (9%), 25 idiopathic pneumonia syndrome (IPS, 7%), 20 multiple organisms (6%), 19 fungal (6%), and 16 Pneumocystis carinii pneumonia (PCP) (5%). The overall cumulative incidence of first pneumonia at 4 years after discharge home was 31%. The cumulative incidences of pneumonia according to donor type at 1 and 4 years after discharge home were 13 and 18% (autologous/syngeneic), 22 and 34% (HLA-matched related), and 26 and 39% (mismatched related/unrelated), respectively. Multivariate analysis of factors associated with development of late pneumonia after allografting were increasing patient age (RR 0.5 for <20 years, 1.2 for >40 years, P=0.009), donor HLA-mismatch (RR 1.6 for unrelated/mismatched related, P=0.01), and chronic graft-versus-host disease (GVHD; RR 1.5, P=0.007). Our data suggest that extension of PCP prophylaxis may be beneficial in high-risk autograft recipients. Further study of long-term anti-infective prophylaxis based on patient risk factors after SCT appear warranted.

Duke Scholars

Published In

Bone Marrow Transplant

DOI

ISSN

0268-3369

Publication Date

September 2003

Volume

32

Issue

5

Start / End Page

515 / 522

Location

England

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Survival Analysis
  • Risk Factors
  • Pneumonia
  • Pneumocystis Infections
  • Middle Aged
  • Male
  • Infection Control
  • Incidence
 

Citation

APA
Chicago
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MLA
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Chen, C.-S., Boeckh, M., Seidel, K., Clark, J. G., Kansu, E., Madtes, D. K., … Sullivan, K. M. (2003). Incidence, risk factors, and mortality from pneumonia developing late after hematopoietic stem cell transplantation. Bone Marrow Transplant, 32(5), 515–522. https://doi.org/10.1038/sj.bmt.1704162
Chen, Chien-Shing, M. Boeckh, K. Seidel, J. G. Clark, E. Kansu, D. K. Madtes, J. L. Wagner, et al. “Incidence, risk factors, and mortality from pneumonia developing late after hematopoietic stem cell transplantation.Bone Marrow Transplant 32, no. 5 (September 2003): 515–22. https://doi.org/10.1038/sj.bmt.1704162.
Chen C-S, Boeckh M, Seidel K, Clark JG, Kansu E, Madtes DK, et al. Incidence, risk factors, and mortality from pneumonia developing late after hematopoietic stem cell transplantation. Bone Marrow Transplant. 2003 Sep;32(5):515–22.
Chen, Chien-Shing, et al. “Incidence, risk factors, and mortality from pneumonia developing late after hematopoietic stem cell transplantation.Bone Marrow Transplant, vol. 32, no. 5, Sept. 2003, pp. 515–22. Pubmed, doi:10.1038/sj.bmt.1704162.
Chen C-S, Boeckh M, Seidel K, Clark JG, Kansu E, Madtes DK, Wagner JL, Witherspoon RP, Anasetti C, Appelbaum FR, Bensinger WI, Deeg HJ, Martin PJ, Sanders JE, Storb R, Storek J, Wade J, Siadak M, Flowers MED, Sullivan KM. Incidence, risk factors, and mortality from pneumonia developing late after hematopoietic stem cell transplantation. Bone Marrow Transplant. 2003 Sep;32(5):515–522.

Published In

Bone Marrow Transplant

DOI

ISSN

0268-3369

Publication Date

September 2003

Volume

32

Issue

5

Start / End Page

515 / 522

Location

England

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Survival Analysis
  • Risk Factors
  • Pneumonia
  • Pneumocystis Infections
  • Middle Aged
  • Male
  • Infection Control
  • Incidence