A Retrospective Review of Infections and Outcomes within D+100 of Hematopoietic Stem Cell Transplantation: Insights from A New Transplant Program in the Philippines

ABSTRACT

Background

Few HSCT are performed in low-middle income countries. Only 4 institutions in the Philippines are transplant capable. This study describes the experience of a newly established program.

Methods

We retrospectively reviewed charts of all adult patients who underwent HSCT at The Medical City from May 1, 2016 to December 31, 2019.

Results

We included 33 patients in the cohort, of whom 31 (93.9%) underwent autologous HSCT and only 2 (6.1%) underwent allogeneic HSCT. Most were female (21/33, 63%) with median age of 51 (range 21 – 67) years. The primary indication for transplantation was multiple myeloma (n=21), followed by diffuse B-cell lymphoma (n=6). 15/33 patients had history of treated TB disease (n=4), or latent TB infection (n=11). The median time for neutrophil recovery was 7.4 (range 4 – 13) days. Transplant complications included neutropenic fever (n=33, 100%) and mucositis (n=14, 42.4%). Bacterial infection was documented in 12 (36.4%) patients with 9 (24.2%) developing a bacterial blood stream infection of which 7 were related to a central line. The overall mortality rate was at 6.1% (2/33) in the first 30 days post-transplant with no additional mortality in the succeeding days until D+100.

Conclusion

: Our cohort with mostly autologous HSCT had favorable outcomes in the first D+100. Rates of bacterial infection were high in the early post-transplant period. Latent TB infection was common but no reactivation was observed. Longer-term follow-up of patients is needed to determine late post-transplant complications and outcomes.