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Title: Impact of cumulative steroid dose on infectious diseases after allogenic hematopoietic stem cell transplantation
Authors: Watanabe, Mizuki
Kanda, Junya  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-6704-3633 (unconfirmed)
Hishizawa, Masakatsu
Kondo, Tadakazu  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-8959-6271 (unconfirmed)
Yamashita, Kouhei
Takaori-Kondo, Akifumi
Author's alias: 諫田, 淳也
菱澤, 方勝
近藤, 忠一
山下, 浩平
髙折, 晃史
Keywords: Transplantation
Infectious Diseases
Issue Date: Apr-2019
Publisher: Blackwell Publishing Inc.
Journal title: Transplant Infectious Disease
Volume: 21
Issue: 2
Thesis number: e13049
Abstract: Background: Systemic steroid is used to treat various transplant‐related complications after allogenic hematopoietic stem cell transplantation (allo‐HSCT). However, measures to evaluate its impact on infections are still limited. Hence, we examined the cumulative steroid dose used within 30 days after transplant as a predictor of future risk of infections. Methods: This study included 226 patients who underwent their first allo‐HSCT at Kyoto University Hospital between 2005 and 2015. Results: Sixty‐one patients received transplantation from related donors, 106 received unrelated BMT and 59 received unrelated single‐unit CBT. Patients were categorized into three groups according to the cumulative steroid dose in terms of prednisolone: no‐steroid group (n = 174), low‐dose group (≤7 mg/kg) (n = 22) and high‐dose group (>7 mg/kg) (n = 30). In a multivariate analysis, high‐dose steroid administration was associated with cytomegalovirus (CMV) antigenemia (HR 1.91, P = 0.037) and bacteremia (HR 2.59, P = 0.053). No impact was found on the occurrence of invasive fungal infection. Conclusion: High‐dose cumulative steroid could predict high risks of bacteremia and CMV antigenemia. Additional anti‐bacterial agents for fever and regular measurement of CMV antigen are recommended for whom with systemic steroid administration even after neutrophil engraftment.
Rights: This is the peer reviewed version of the following article: Watanabe, M, Kanda, J, Hishizawa, M, Kondo, T, Yamashita, K, Takaori‐Kondo, A. Impact of cumulative steroid dose on infectious diseases after allogenic hematopoietic stem cell transplantation. Transpl Infect Dis. 2019; 21:e13049., which has been published in final form at https://doi.org/10.1111/tid.13049. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
The full-text file will be made open to the public on 5 April 2020 in accordance with publisher's 'Terms and Conditions for Self-Archiving'
This is not the published version. Please cite only the published version. この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。
URI: http://hdl.handle.net/2433/240763
DOI(Published Version): 10.1111/tid.13049
PubMed ID: 30656802
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