Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

The incidence and impact of clostridioides difficile infection on transplant outcomes in acute leukemia and MDS after allogeneic hematopoietic cell transplant-a CIBMTR study. Bone Marrow Transplant 2023 Apr;58(4):360-366

Date

12/22/2022

Pubmed ID

36543999

Pubmed Central ID

PMC10079570

DOI

10.1038/s41409-022-01896-z

Scopus ID

2-s2.0-85144532838 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

Clostridioides difficile infection (CDI) is common after allogeneic hematopoietic cell transplantation (alloHCT). The determination of incidence, risk factors, and impact of CDI on alloHCT outcomes is an unmet need. The study examines all patients aged 2 years and older who received first alloHCT for acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), or myelodysplastic syndrome (MDS) between 2013 and 2018 at US centers and reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) data registry. In total, 826 patients with CDI and 6723 controls from 127 centers were analyzed. The cumulative incidence of CDI by day 100 was 18.7% (99% CI: 15-22.7%) and 10.2% (99% CI: 9.2-11.1%) in pediatric and adult patients, respectively, with a median time to diagnosis at day +13. CDI was associated with inferior overall survival (OS) (p = 0.0018) and a 2.58-fold [99% CI: 1.43-4.66; p < 0.001] increase in infection-related mortality (IRM). There was a significant overlap in the onset of acute graft versus host disease (aGVHD) and CDI. IRM increased to >4 fold when CDI + aGVHD was considered. Despite advances in the management of CDI, increased IRM and decreased OS still results from CDI.

Author List

Ramanathan M, Kim S, He N, Chen M, Hematti P, Abid MB, Rotz SJ, Williams KM, Lazarus HM, Wirk B, Yin DE, Kanakry CG, Perales MA, Chemaly RF, Dandoy CE, Riches M, Ustun C

Authors

Peiman Hematti MD Professor in the Medicine department at Medical College of Wisconsin
Soyoung Kim PhD Associate Professor in the Data Science Institute department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Child
Clostridium Infections
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Incidence
Leukemia, Myeloid, Acute
Myelodysplastic Syndromes
Retrospective Studies
Transplantation, Homologous