Pneumonia in allogeneic stem cell transplantation recipients: a multicenter prospective study

• Published in: Clinical transplantation Vol. 25; no. 6; pp. E629 - E638
• Main Authors: Aguilar-Guisado, Manuela, Jiménez-Jambrina, Margarita, Espigado, Ildefonso, Rovira, Montserrat, Martino, Rodrigo, Oriol, Albert, Borrell, Nuria, Ruiz, Isabel, Martín-Dávila, Pilar, de la Cámara, Rafael, Salavert, Miquel, de la Torre, Julián, Cisneros, José Miguel
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.11.2011
• Subjects: Adult; epidemiology; Female; Follow-Up Studies; Graft vs Host Disease - epidemiology; Graft vs Host Disease - etiology; Graft vs Host Disease - mortality; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Incidence; Male; multicenter studies; pneumonia; Pneumonia - epidemiology; Pneumonia - etiology; Pneumonia - mortality; post-transplant infections; Prognosis; Prospective Studies; stem cell transplantation; Survival Rate; Transplantation, Homologous
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/j.1399-0012.2011.01495.x

Aguilar‐Guisado M, Jiménez‐Jambrina M, Espigado I, Rovira M, Martino R, Oriol A, Borrell N, Ruiz I, Martín‐Dávila P, de la Cámara R, Salavert M, de la Torre J, Cisneros JM, on behalf of Spanish Network for Research in Infectious Diseases. Pneumonia in allogeneic stem cell transplantation recipients: a multicenter prospective study. 
Clin Transplant 2011: 25: E629–E638. © 2011 John Wiley & Sons A/S. :  Pneumonia is a common cause of mortality after allogeneic hematopoietic stem cell transplantation (allo‐HSCT) but updated and prospective information is partial. The aim of this nationwide prospective study is to determine the current epidemiology, etiology, and outcome of pneumonia in allo‐HSCT recipients. From September‐2003 to November‐2005, 112 episodes in 427 consecutive allo‐HSCT recipients were included (incidence 52.2 per 100 allo‐HSCT/yr), and 72 of them (64.3%) were microbiologically defined pneumonia. Bacterial pneumonia (44.4%) was more frequent than fungal (29.2%) and viral pneumonia (19.4%). The most frequent microorganisms in each group were: Escherichia coli (n = 7, 8.9%), Streptococcus pneumoniae (n = 4, 5.0%), cytomegalovirus (n = 12, 15.4%), and Aspergillus spp. (n = 12, 15.4%). The development of pneumonia and chronic graft‐versus‐host disease (GVHD) was associated with increased mortality after allo‐HSCT, and the probability of survival was significantly lower in patients that had at least one pneumonia episode (p < 0.01). Pneumonia development in the first 100 d after transplantation, fungal etiology, GVHD, acute respiratory failure, and septic shock were associated with increased mortality after pneumonia. Our results show that pneumonia remains a frequent infectious complication after allo‐HSCT, contributing to significant mortality, and provide a large current experience with the incidence, etiology and outcome of pneumonia in these patients.