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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Br+J+Haematol
2020 ; 188
(4
): 560-569
Nephropedia Template TP
gab.com Text
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English Wikipedia
Delaying haematopoietic stem cell transplantation in children with viral
respiratory infections reduces transplant-related mortality
#MMPMID31566733
Ottaviano G
; Lucchini G
; Breuer J
; Furtado-Silva JM
; Lazareva A
; Ciocarlie O
; Elfeky R
; Rao K
; Amrolia PJ
; Veys P
; Chiesa R
Br J Haematol
2020[Feb]; 188
(4
): 560-569
PMID31566733
show ga
Viral respiratory infections (VRIs) contribute to the morbidity and
transplant-related mortality (TRM) after allogeneic haematopoietic stem cell
transplantation (HSCT) and strategies to prevent and treat VRIs are warranted. We
monitored VRIs before and after transplant in children undergoing allogeneic HSCT
with nasopharyngeal aspirates (NPA) and assessed the impact on clinical outcome.
Between 2007 and 2017, 585 children underwent 620 allogeneic HSCT procedures. Out
of 75 patients with a positive NPA screen (12%), transplant was delayed in 25
cases (33%), while 53 children started conditioning with a VRI. Patients
undergoing HSCT with a positive NPA screen had a significantly lower overall
survival (54% vs. 79%) and increased TRM (26% vs. 7%) compared to patients with a
negative NPA. Patients with a positive NPA who delayed transplant and cleared the
virus before conditioning had improved overall survival (90%) and lower TRM (5%).
Pre-HSCT positive NPA was the only significant risk factor for progression to a
lower respiratory tract infection and was a major risk factor for TRM. Transplant
delay, whenever feasible, in case of a positive NPA screen for VRIs can
positively impact on survival of children undergoing HSCT.