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. 2016 Sep 14;11(9):e0162178.
doi: 10.1371/journal.pone.0162178. eCollection 2016.

Infectious Complications during Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation for Children with High-Risk or Recurrent Solid Tumors

Young Bae Choi  1 , Eun Sang Yi  2 , Ji-Man Kang  2 , Ji Won Lee  2 , Keon Hee Yoo  2 , Yae-Jean Kim  2 , Ki Woong Sung  2 , Hong Hoe Koo  2
Affiliations

Infectious Complications during Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation for Children with High-Risk or Recurrent Solid Tumors

Young Bae Choi et al. PLoS One. .

Abstract

We retrospectively analyzed infectious complications during tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT) in children and adolescents with high-risk or recurrent solid tumors. A total of 324 patients underwent their first HDCT/auto-SCT between October 2004 and September 2014, and 283 of them proceeded to their second HDCT/auto-SCT (a total of 607 HDCT/auto-SCTs). During the early transplant period of 607 HDCT/auto-SCTs (from the beginning of HDCT to day 30 post-transplant), bacteremia, urinary tract infection (UTI), respiratory virus infection, and varicella zoster virus (VZV) reactivation occurred in 7.1%, 2.3%, 13.0%, and 2.5% of HDCT/auto-SCTs, respectively. The early transplant period of the second HDCT/auto-SCT had infectious complications similar to the first HDCT/auto-SCT. During the late transplant period of HDCT/auto-SCT (from day 31 to 1 year post-transplant), bacteremia, UTI, and VZV reactivation occurred in 7.5%, 2.5%, and 3.9% of patients, respectively. Most infectious complications in the late transplant period occurred during the first 6 months post-transplant. There were no invasive fungal infections during the study period. Six patients died from infectious complications (4 from bacterial sepsis and 2 from respiratory virus infection). Our study suggests that infectious complications are similar following second and first HDCT/auto-SCT in children.

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Conflict of interest statement

The authors received funding from Astellas Pharma Korea, Inc., a commercial company, for this study. There are no patents, products in development, or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Respiratory virus infections during the early transplant period of tandem HDCT/auto-SCT.
Number of isolates and respiratory symptoms for each respiratory virus during the first (A) and second (B) HDCT/auto-SCT. (C) The high-risk RV group had a higher incidence of LRTI than the low-risk RV group (43.5% versus 10.0%, p = 0.005). HDCT/auto-SCT, high-dose chemotherapy and autologous stem cell transplantation; URI, upper respiratory infection; LRTI, lower tract respiratory infection; RhV, rhinovirus; RSV, respiratory syncytial virus; CoV, coronavirus; PIV, parainfluenza virus; IV, influenza virus; AdV, adenovirus; RV, respiratory virus.
See this image and copyright information in PMC

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