Decrease of lethal infectious complications in the context of causes of death (COD) after hematopoietic cell transplantation: COD-2 and COD-1 study of the Infectious Diseases Working Party EBMT.
Jan Styczynski
(1)
,
Gloria Tridello
(2, 3)
,
Linda Koster
(2)
,
Nina Knelange
(2)
,
Lotus Wendel
(2)
,
Anja van Biezen
(2)
,
Steffie van der Werf
(2)
,
Malgorzata Mikulska
(4)
,
Lidia Gil
(5)
,
Catherine Cordonnier
(6)
,
Per Ljungman
(7)
,
Diana Averbuch
(8)
,
Simone Cesaro
(9)
,
Helen Baldomero
(10)
,
Christian Chabannon
(11, 12)
,
Selim Corbacioglu
(13)
,
Harry Dolstra
(14)
,
Bertram Glass
(15)
,
Raffaella Greco
(16)
,
Nicolaus Kröger
(17)
,
Régis Peffault de Latour
(18)
,
Mohamad Mohty
(19)
,
Benedicte Neven
(20)
,
Zinaida Peric
(21)
,
John A. Snowden
(22)
,
Anna Sureda
(23)
,
Ibrahim Yakoub-Agha
(24)
,
Rafael de la Camara
(25)
1
Nicolaus Copernicus University [Toruń]
2 LUMC - Leiden University Medical Center
3 Azienda Ospedaliera Universitaria Integrata of Verona
4 Ospedale Policlinico San Martino [Genoa]
5 PUMS - Poznan University of Medical Sciences [Poland]
6 Hôpital Henri Mondor
7 Karolinska University Hospital [Stockholm]
8 Hadassah Hebrew University Medical Center [Jerusalem]
9 UNIVR - Università degli studi di Verona = University of Verona
10 University Hospital Basel [Basel]
11 IPC - Institut Paoli-Calmettes
12 CRCM - Centre de Recherche en Cancérologie de Marseille
13 University of Regensburg
14 Radboud University Medical Center [Nijmegen]
15 Helios Klinikum [Erfurt]
16 IRCCS Ospedale San Raffaele [Milan, Italy]
17 University Hospital Hamburg-Eppendorf
18 AP-HP - Hopital Saint-Louis [AP-HP]
19 CHU Saint-Antoine [AP-HP]
20 Hôpital Necker - Enfants Malades [AP-HP]
21 University Hospital Centre Zagreb
22 Sheffield Children's NHS Foundation Trust
23 IDIBELL - Institut d'Investigació Biomèdica de Bellvitge = Bellvitge Biomedical Research Institute
24 LIRIC - Lille Inflammation Research International Center - U 995
25 Hospital Universitario de La Princesa
2 LUMC - Leiden University Medical Center
3 Azienda Ospedaliera Universitaria Integrata of Verona
4 Ospedale Policlinico San Martino [Genoa]
5 PUMS - Poznan University of Medical Sciences [Poland]
6 Hôpital Henri Mondor
7 Karolinska University Hospital [Stockholm]
8 Hadassah Hebrew University Medical Center [Jerusalem]
9 UNIVR - Università degli studi di Verona = University of Verona
10 University Hospital Basel [Basel]
11 IPC - Institut Paoli-Calmettes
12 CRCM - Centre de Recherche en Cancérologie de Marseille
13 University of Regensburg
14 Radboud University Medical Center [Nijmegen]
15 Helios Klinikum [Erfurt]
16 IRCCS Ospedale San Raffaele [Milan, Italy]
17 University Hospital Hamburg-Eppendorf
18 AP-HP - Hopital Saint-Louis [AP-HP]
19 CHU Saint-Antoine [AP-HP]
20 Hôpital Necker - Enfants Malades [AP-HP]
21 University Hospital Centre Zagreb
22 Sheffield Children's NHS Foundation Trust
23 IDIBELL - Institut d'Investigació Biomèdica de Bellvitge = Bellvitge Biomedical Research Institute
24 LIRIC - Lille Inflammation Research International Center - U 995
25 Hospital Universitario de La Princesa
Résumé
We previously analyzed trends in incidence and factors associated with lethal complications in ALL/AML/CML patients (causes of deaths; COD-1 study). The objective of this study was the analysis of incidence and specific causes of death after HCT, with focus on infectious deaths in two time periods, 1980–2001 (cohort-1) and 2002–2015 (cohort-2). All patients with HCT for lymphoma, plasma cell disorders, chronic leukemia (except CML), myelodysplastic/myeloproliferative disorders, registered in the EBMT-ProMISe-database were included (n = 232,618) (COD-2 study). Results were compared to those in the ALL/AML/CML COD-1 study. Mortality from bacterial, viral, fungal, and parasitic infections decreased in very early, early and intermediate phases. In the late phase, mortality from bacterial infections increased, while mortality from fungal, viral, or unknown infectious etiology did not change. This pattern was similar for allo- and auto-HCT in COD-1 and COD-2 studies, with a distinct and constant lower incidence of all types of infections at all phases, after auto-HCT. In conclusion, infections were the main cause of death before day +100, followed by relapse. Mortality from infectious deaths significantly decreased, except late phase. Post-transplant mortality has significantly decreased in all phases, from all causes after auto-HCT; it has decreased in all phases after allo-HCT except late phase.