Detalle Publicación

Low rate of infectious enterocolitis in allogeneic stem cell transplant recipients with acute diarrhea: a prospective study by the GETH-TC

Autores: Redondo Velao, S. (Autor de correspondencia); García Cadenas, I.; Ángeles Cuesta, M.; Sánchez-Ortega, I.; Fernández-Avilés, F.; Roldan, E.; Torrent, A.; Viguria, M.C.; Villar Fernández, Sara; Bento, L.; Yánez, L.; Martino, R.; Pinana, J.L.
Título de la revista: ACTA HAEMATOLOGICA
ISSN: 0001-5792
Volumen: 146
Número: 2
Páginas: 161 - 165
Fecha de publicación: 2023
Acute diarrhea is a common and debilitating complication in recipients of an allogeneic hematopoietic stem cell transplantation (HCT). In this prospective, observational, and multi-center study we examined all episodes occurring in the first 6 months of 142 consecutive adult patients who underwent a reduced-intensity conditioning (RIC) HCT in 10 Spanish tertiary University Hospitals. Fifty-four patients (38%) developed a total of 75 acute diarrhea episodes. The median time from HCT to the first episode was 38 days (4-157). The main cause of enterocolitis was lower GI-aGVHD (38%), followed by infections (21%) and drug-related toxicity (8%). Causative infectious causes were identified in only 16/75 episodes (21%). C. difficile-related infection (CDI) was the most common infectious agent with an incidence and recurrence of 13% and 2%, respectively. With a median follow-up for survivors of 32 months, the NRM and the overall survival (OS) at 1 year, were 20% (95% C.I.: 14-28%) and 69% (95% C.I.: 61-77%), respectively. Development of enterocolitis was not associated with higher NRM (p = 0.37) or worse OS (p = 0.9). This real-life study confirms that the diagnosis and management of acute diarrhea in the early stages after HCT is challenging. Nosocomial infections, seem to be relatively uncommon, probably due to more rational use of antibiotics.