Infectious complications after allogeneic bone marrow transplantation: Sheikha Badryia Center, Kuwait

ABSTRACT

To present our experience of post-transplant infections in allogeneic stem cell transplants at Sheikha Badryia Stem Cell Transplant Centre, Kuwait. Retrospective analysis of 21 consecutive patients with malignant and non-malignant hematological disorders who received a transplant of an unmanipulated bone marrow graft from an HLA-I identical sibling donor from November 2011 to December 2013. Pre-transplant infection surveillance was carried out, and strict prophylaxis against infection was observed. Bone marrow stem | cells were used as the stem cell source. Cyclosporin and methotrexate with or without mycophenolate mofetil / methylprednisolone were used as graft-versus-host disease [GVHD] prophylaxis. The engraftment was monitored with molecular analysis. Survival was calculated from the date of transplant to death or last follow-up. Twenty-one patients received allogeneic stem cell transplants from HLA- matched siblings for various hematological disorders. Twelve patients were female. The median age of the patient cohort was 34 years [range 3-41 years]. All patients and donors were cytomegalovirus [CMV] IgG-positive. Seventeen patients [80.95%] developed febrile episodes in different phases of post-transplant recovery. Post-transplant infections were confirmed in 20 patients [90.2%] on the basis of clinical assessment and microbiological, virological, and histopathological examination. Mortality related to infections and chronic graft versus host disease was one patient [4.8%]. 90% of our patients developed febrile episodes with relatively low culture yield. The majority of infections were treated effectively