Abstract
The 12-month mortality rate in patients undergoing hematopoietic stem cell transplantation (HSCT) remains high, especially with respect to transplant-related mortality (TRM), which includes mortality due to infection complications through the aplasia phase. The aim of this study was to determine whether the administration of Pentaglobin® could decrease TRM by lowering sepsis onset or weakening sepsis through the aplasia phase. One hundred and ninety-nine pediatric patients who had undergone HSCT were enrolled in our retrospective study. The patients were divided into two groups: the Pentaglobin group, which had received Pentaglobin® in addition to the standard antibiotic treatment protocol established for the aplasia phase, and the Control group, which received only the standard treatment. As compared to the control group outcome, Pentaglobin® led to a significant decrease in the days of temperature increase (p < 0.001) and a reduced infection-related mortality rate (p = 0.04). In addition, the number of antibiotics used to control infections, and the number of antibiotic therapy changes needed following first-line drug failure, were significantly lowered in the Pentaglobin group as compared to the control group (p < 0.0001). With respect to the onset of new infections following the primary infection detected, the Pentaglobin group showed a significant reduction for bacterial events, as compared to the control group (p < 0.03). Pentaglobin® use in patients undergoing HSCT seems to produce a significant decrease in infection-associated TRM rate.
Highlights
Hematopoietic stem cell transplantation (HSCT) is the most efficient consolidation therapy in some hematologic malignancies such as acute lymphoblastic leukemia and acute myeloid leukemia
The patients were divided into two groups: the Pentaglobin group, which had received Pentaglobin® in addition to the standard antibiotic treatment protocol established for the aplasia phase, and the Control group, which received only the standard treatment
Progress has been achieved in transplantation medicine with respect to high-resolution donor-recipient human leukocyte antigen (HLA) matching, conditioning regimens for hematopoietic stem cell transplantation (HSCT), graft-versus-host disease (GVHD), and strict infection control
Summary
Hematopoietic stem cell transplantation (HSCT) is the most efficient consolidation therapy in some hematologic malignancies such as acute lymphoblastic leukemia and acute myeloid leukemia. HSCT is a potential therapy for patients with solid tumors, genetic, hematological and metabolic disorders, and primary immunodeficiency diseases [1,2,3,4]. HSCT results in a variety of severe complications responsible for a high rate of morbidity and mortality in transplant recipients [5]. Progress has been achieved in transplantation medicine with respect to high-resolution donor-recipient human leukocyte antigen (HLA) matching, conditioning regimens for HSCT, graft-versus-host disease (GVHD), and strict infection control. This has improved clinical outcomes by decreasing the rate of transplant-related mortality (TRM) [6,7]. All scientific societies consider the current mortality rate, of about 10% of transplant recipients on average during a 12-month follow-up period, to still be too high, so they identified a new primary endpoint at a lower rate, which remained below 10% [8]
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