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

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