Factors associated with GVHD and with poor immune reconstitution are among the risk factors for PJP and suggest that protracted prophylaxis for PJP in high-risk HSCT recipients may improve outcomes.read more read lessĪbstract: BACKGROUND: Paroxysmal nocturnal haemoglobinuria (PNH) is a rare disease. We conclude PJP infection is rare after HSCT but is associated with high mortality. After controlling for significant variables, the proportional hazards model revealed that PJP cases were 6.87 times more likely to die vs matched controls (P<0.0001). After allo or auto HSCT, overall survival was significantly poorer among cases vs controls (P=0.0004). A nested case cohort analysis with supplemental data (n=68 allo cases, n=111 allo controls) revealed that risk factors for PJP infection included lymphopenia and mismatch after HSCT. Cases occurred as early as 30 days to beyond a year after allo HSCT. Between 19, 0.63% allo recipients and 0.28% auto recipients of first HSCT developed PJP. We report the results of a Center for International Blood and Marrow Transplant Research study evaluating the incidence, timing, prophylaxis agents, risk factors and mortality of PJP after autologous (auto) and allogeneic (allo) HSCT. Little is known about PJP infections after HSCT because of the rarity of disease given routine prophylaxis. Major increases were observed in allogeneic, haploidentical HSCT and, to a lesser extent, in cord blood transplantation.read more read lessĪbstract: Pneumocystis jiroveci pneumonia (PJP) is associated with high morbidity and mortality after hematopoietic stem cell transplantation (HSCT). In conclusion, global HSCT grows over the years without plateauing (allogeneic>autologous) and at different rates in the four World Health Organization regions. The limited data collection remains its major weakness and threat.
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A Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis revealed the global perspective of WBMT to be its major strength and identified potential to be the key professional body for patients and authorities. An increase of 167% was noted in mismatched/haploidentical family HSCT. Growth was due to an increase in reporting teams (18%) and median transplant activity/team (from 38 to 48 HSCTs/team). Compared with 2006, an increase of 46% total (57% allogeneic and 38% autologous) was observed. Grafts were collected from peripheral blood (66%), bone marrow (24% mainly non-malignant disorders) and cord blood (10%). With transplant rates ranging from 0.1 to 1001 per 10 million inhabitants, more HSCTs were registered from unrelated 16 433 donors than related 15 493 donors. Abstract: Data on 68 146 hematopoietic stem cell transplants (HSCTs) (53% autologous and 47% allogeneic) gathered by 1566 teams from 77 countries and reported through their regional transplant organizations were analyzed by main indication, donor type and stem cell source for the year 2012.
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