TY  - JOUR
A1  - Scheich, Sebastian
A1  - König, Rosalie
A1  - Wilke, Anne
A1  - Lindner, Sarah
A1  - Reinheimer, Claudia
A1  - Wichelhaus, Thomas Alexander
A1  - Hogardt, Michael
A1  - Kempf, Volkhard A. J.
A1  - Kessel, Johanna
A1  - Weber, Sarah
A1  - Martin, Hans
A1  - Bug, Gesine
A1  - Serve, Hubert
A1  - Steffen, Björn
T1  - Stenotrophomonas maltophilia colonization during allogeneic hematopoietic stem cell transplantation is associated with impaired survival
T2  - PLoS one
N2  - Allogeneic hematopoietic stem cell transplantation (allo-HSCT) offers potential cure to acute myeloid leukemia (AML) patients. However, infections with commensal bacteria are an important cause for non-relapse mortality (NRM). We have previously described the impact of multidrug-resistant organism (MDRO) colonization on the survival of allo-HSCT patients. In the aforementioned publication, according to consensus, we there did not consider the opportunistic gram-negative bacterium Stenotrophomonas maltophilia (S. maltophilia) to be an MDRO. Since rate of S. maltophilia colonization is increasing, and it is not known whether this poses a risk for allo-HSCT patients, we here analyzed here its effect on the previously described and now extended patient cohort. We report on 291 AML patients undergoing allo-HSCT. Twenty of 291 patients (6.9%) were colonized with S. maltophilia. Colonized patients did not differ from non-colonized patients with respect to their age, remission status before allo-HSCT, donor type and HSCT-comorbidity index. S. maltophilia colonized patients had a worse overall survival (OS) from 6 months up to 60 months (85% vs. 88.1% and 24.7% vs. 59.7%; p = 0.007) due to a higher NRM after allo-HSCT (6 months: 15% vs. 4.8% and 60 months: 40.1% vs. 16.2% p = 0.003). The main cause of mortality in colonized patients was infection (46.2% of all deaths) and in non-colonized patients relapse (58.8% of all deaths). 5/20 colonized patients developed an invasive infection with S. maltophilia. The worse OS after allo-HSCT due to higher infection related mortality might implicate the screening of allo-HSCT patients for S. maltophilia and a closer observation of colonized patients as outpatients.
KW  - Stenotrophomonas maltophilia
KW  - Hematopoietic stem cell transplantation
KW  - Acute myeloid leukemia
KW  - Intensive care units
KW  - Multivariate analysis
KW  - Neutropenia
KW  - Bloodstream infections
KW  - Gram negative bacteria
Y1  - 2018
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/46859
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-468597
SN  - 1932-6203
N1  - Copyright: © 2018 Scheich et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
VL  - 13
IS  - (7): e0201169
SP  - 1
EP  - 14
PB  - PLoS
CY  - Lawrence, Kan.
ER  -