Iron overload is a major risk factor for severe infection after autologous stem cell transplantation: a study of 367 myeloma patients

Bone Marrow Transplantation
M H MiceliE J Anaissie

Abstract

We evaluated the risk factors for infection of 367 consecutive myeloma patients who underwent high-dose melphalan and autologous stem cell transplantation (ASCT). Examination of bone marrow iron stores (BMIS) prior to ASCT was used to evaluate body iron stores. Other variables included age, sex, active smoking, myeloma remission status, severity of mucositis and duration of severe neutropenia post-ASCT (<100 absolute neutrophils counts (ANC)/microl). Median age was 56 years; 61% of patients were males. 140 episodes of severe infections occurred in 116 patients, including bacteremia (73), pneumonia (40), severe colitis (25) and bacteremia with septic shock (two). The infection incidence per 1,000 days at risk was 45.2. Pre-ASCT risk factors for severe infection by univariate analysis were increased BMIS (OR=2.686; 95% CI 1.707-4.226; P<0.0001), smoking (OR=1.565; 95% CI 1.005-2.437; P=0.0474) and male gender (OR=1.624; 95% CI 1.019-2.589; P=0.0414). Increased BMIS (OR=2.716; 95% CI 1.720-4.287; P<0.0001) and smoking (OR=1.714; 95% CI 1.081-2.718; P=0.022) remained significant by multivariate analysis. Duration of ANC <100 micro/l (OR=1.129; 95% CI 1.039-1.226; P=0.0069 and OR=1.127; 95% CI 1.038-1.224; P=0.0045 by both univariat...Continue Reading

References

Jun 1, 1988·American Journal of Infection Control·J S GarnerJ M Hughes
Jun 1, 1997·The Journal of Infectious Diseases·A MencacciL Romani
Apr 18, 1998·The American Journal of Tropical Medicine and Hygiene·P E ThumaV R Gordeuk
Aug 26, 1998·Bone Marrow Transplantation·S I StrasserG B McDonald
Mar 4, 1999·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·E A EngelsJ B Wong
Mar 9, 2000·The New England Journal of Medicine·J P NuortiR F Breiman
Apr 15, 2000·Journal of Clinical Apheresis·K M Grima
Jun 1, 2000·Transfusion Science·M Valbonesi, R Bruni
Feb 13, 2001·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·M S GomesR Appelberg
Feb 15, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·T BartonM Schuster
Feb 15, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J H RexJ E Edwards
Mar 17, 2001·Scandinavian Journal of Gastroenterology·M HöpfnerU R Fölsch
Aug 10, 2001·Scandinavian Journal of Gastroenterology·T K BergmannH Hey
Feb 19, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Walter T HughesLowell S Young
May 23, 2002·Antimicrobial Agents and Chemotherapy·Biliana LesicElisabeth Carniel
Sep 18, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Shih-Chung WangKuo-Sin Lin
Nov 25, 2003·Hematology·Ernest BeutlerJames D Cook
Nov 25, 2003·Hematology·Susan N O'BrienElias J Anaissie
Mar 16, 2004·British Journal of Haematology·Guido TricotFrits Van Rhee
Apr 9, 2004·Lancet·Y GandonY Deugnier
Apr 20, 2004·Biometals : an International Journal on the Role of Metal Ions in Biology, Biochemistry, and Medicine·Sharon MoalemMaire E Percy
Nov 10, 2004·Archives of Internal Medicine·Lidia Arcavi, Neal L Benowitz
Nov 20, 2004·Nature Reviews. Microbiology·Ulrich E Schaible, Stefan H E Kaufmann
Feb 15, 2005·FEMS Immunology and Medical Microbiology·John J BullenCharles G Ward
Oct 12, 2005·Current Opinion in Hematology·Gösta Gahrton

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Citations

Feb 7, 2007·Annals of Hematology·Albert AltesJorge Sierra
May 9, 2012·Folia Microbiologica·Lenka Bašková, Vladimír Buchta
Aug 7, 2013·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Serdar SivginAli Unal
Sep 11, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Carol Garcia-VidalKieren A Marr
Jun 29, 2010·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jennifer K ChowDavid R Snydman
Oct 27, 2009·Journal of Hematology & Oncology·Jonathan A StoreyIstván Molnár
Jun 6, 2013·PloS One·Ji Won LeeHyo Seop Ahn
Aug 7, 2009·Journal of Periodontology·Fernando VerdugoJosé Pontón
Mar 17, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Simone Aranha NouérElias Anaissie
Apr 16, 2014·Bone Marrow Transplantation·S L EhlersD Gastineau
Sep 28, 2010·Advances in Hematology·Vinod Pullarkat
Sep 6, 2007·The Journal of Clinical Investigation·Ashraf S IbrahimBrad J Spellberg
May 28, 2011·Free Radical Research·Shinya Toyokuni
Apr 4, 2013·Expert Review of Hematology·Mehmet A ÖzcanZafer Gülbas
Sep 19, 2012·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Serdar SivginAli Unal
Jan 18, 2011·Hematology/oncology Clinics of North America·Anna K PersonBarbara D Alexander
Jul 14, 2010·Transplantation Proceedings·G T SucakM Yağci
May 15, 2010·Infectious Disease Clinics of North America·Anna K PersonBarbara D Alexander
Mar 23, 2010·Biochimica Et Biophysica Acta·Wei WangSuzy V Torti
Jun 25, 2009·Seminars in Hematology·Marcio Nucci, Elias Anaissie
Oct 1, 2015·Journal of Pediatric Hematology/oncology·Ashley SchemppAngela R Smith
Jul 18, 2008·Leukemia Research·Navneet S MajhailLinda J Burns
Aug 30, 2008·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Nina Singh, Hsin-Yun Sun
Nov 6, 2007·British Journal of Haematology·Penelope D Barnes, Kieren A Marr
Aug 7, 2012·The Journal of Pathology·Li JiangShinya Toyokuni
Feb 12, 2011·International Journal of Laboratory Hematology·Z A YeginG T Sucak
Apr 15, 2014·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Ryoji KobayashiSeiji Kojima
Dec 2, 2009·The Korean Journal of Internal Medicine·Moo-Kon SongGoon-Jae Cho
Jun 21, 2007·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Sung-Yong KimChun-Choo Kim
Jan 27, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Keisuke KataokaMineo Kurokawa
Jul 11, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Junya KandaTakashi Uchiyama
Oct 23, 2008·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Anuj MahindraEdward Copelan
Mar 24, 2010·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Ozlem Güzel TunçcanGülsan Sucak
Aug 14, 2009·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Z ErjavecP E Verweij

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