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. 2023 Aug;58(8):881-892.
doi: 10.1038/s41409-023-01998-2. Epub 2023 May 6.

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  3 , Nina Knelange  3 , Lotus Wendel  3 , Anja van Biezen  3 , Steffie van der Werf  3 , Malgorzata Mikulska  4 , Lidia Gil  5 , Catherine Cordonnier  6 , Per Ljungman  7 , Diana Averbuch  8 , Simone Cesaro  2 , Helen Baldomero  9 , Christian Chabannon  10 , Selim Corbacioglu  11 , Harry Dolstra  12 , Bertram Glass  13 , Raffaella Greco  14 , Nicolaus Kröger  15 , Régis Peffault de Latour  16 , Mohamad Mohty  17 , Benedicte Neven  18 , Zinaida Peric  19 , John A Snowden  20 , Anna Sureda  21 , Ibrahim Yakoub-Agha  22 , Rafael de la Camara  23
Affiliations

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 et al. Bone Marrow Transplant. 2023 Aug.

Abstract

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.

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References

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