Infection rates in children with acute lymphoblastic leukemia who receive stem-cell transplant from unrelated donors

This study aimed to investigate infection rates in children with acute lymphoblastic leukemia who received stem cell transplant from unrelated donors.  This study concluded that these patients experience higher infection rates than other patients.  

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a procedure in which a person receives blood-forming stem cells from a genetically similar, but not identical, donor. This is often a sister or brother. It could also be from an unrelated donor. Patients with acute lymphoblastic leukemia (ALL) may receive allo-HSCT as treatment.  

Severe infections (SI) can impact on non-relapse mortality (death not related to cancer) after allo-HSCT. The infection rates in children with ALL who received allo-HSCT from unrelated donors are still under investigation.  

This study involved 432 children and adolescents with ALL who had allo-HSCT. SIs were measured.  

40% of patients experienced at least one SI. Transplantation from matched unrelated donors (MUD) was associated with higher rates if SIs (32%) compared to those transplanted from matched sibling donors (MSD; 16%) in the first 30 days. Transplantation from MUD was also associated with a higher risk of SIs between day 30 and 100 compared to MSD (23% vs 6%).

Bacterial and fungal infections occurred more often in the period before engraftment when compared to matched sibling donors. Engraftment is when transplanted cells start to produce healthy blood cells in patients' bone marrow. Viral infections occurred more often before day 30 or between day 30 and 100 after HSCT from MUD when compared to matched sibling donors.  

Chronic graft-versus-host disease (GvHD) was a risk factor for any type of SI after day 100. GvHD is a reaction that occurs after a transplant when the donor and patient are different people. It involves the donated cells attacking the patients. 

This study concluded that children with ALL who receive allo-HSCT from unrelated donors have high infection rates.  

This study was based on medical records. Some information was missing. This might have affected the results.