The following is a summary of “Incidence of bacterial blood stream infections in patients with acute GVHD,” published in the October 2024 issue of Hematology by Wallis et al. 

Bacterial bloodstream infections (BSI) significantly contributed to the complications in treating graft-versus-host disease (GVHD).  

Researchers conducted a retrospective study to evaluate the risk of BSI from neutrophil engraftment through day 100 post-transplants in patients with acute GVHD (AGVHD), considering organ involvement and severity.  

They analyzed data from 4,064 patients who underwent allogeneic hematopoietic stem cell transplant (HCT) as reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) registry.  

The results showed that 1,607 patients (39.5%) developed grade II-IV AGVHD, which was linked to a higher day-100 incidence of post-engraftment BSI compared to grade 0/I (24.9% vs 15.3%). Patients with grade III/IV AGVHD had the highest BSI risk (HR 2.45; 95% CI 1.99–3.0; P < 0.0001). Lower gastrointestinal (GI) involvement also increased the risk of BSI (HR 1.54; 95% CI 1.17–2.02; P = 0.0019). Post-engraftment BSI through day 100 was associated with poorer survival (HR 1.64; 95% CI 1.43–1.87; P < 0.001) and elevated non-relapse mortality (NRM) (HR 2.22; 95% CI 1.91–2.59; P < 0.001).  

They concluded individuals with stage III/IV gastrointestinal involvement were at the highest risk for BSI.   

Source: nature.com/articles/s41409-024-02426-9#Abs1