Infectious Causes of Early Mortality After Hematopoietic Stem Cell Transplantation

Infectious complications are a common cause of morbidity and mortality in patients with hematological malignancies. We aimed to identify the infectious causes of mortality after hematopoietic stem cell transplantation (HSCT). This observational retrospective study included >18 years old adults who underwent HSCT because of hematological malignancies at Koç University Hospital. From 2016 to 2024, a total of 500 patients were evaluated. Mortality rates and infectious causes were recorded for 30 days, 100 days and 1 year. STATA was used for statistical analysis. Patients were diagnosed with non-Hodgkin lymphoma (%36), multiple myeloma (%33), Hodgkin lymphoma (%12), acute myeloid leukemia (%9), acute lymphoblastic leukemia (%5) and myelodysplastic syndrome (%2). Table-1 shows the impact of demographic characteristics and biochemical markers on 30-day fatality. Allogenic HSCT and admission to the intensive care unit were revealed to be significant factors in mortality. Gram negative bloodstream infections (BSI) among 500 patients and carbapenem resistance (CR) rates were shown in Figure-1. Gram positive BSI rate was %7 (n=34). Central venous catheter (CVC) -related BSI were most common (%74). CR- Klebsiella pneumoniae BSI and allogenic HSCT were identified as predictors of 30-day fatality (Table-2). Overall mortality rates were %5 in 30-day, %10 in 100-days and %20 in 1 year. Bloodstream infections caused by CR- Klebsiella pneumoniae were significantly associated with 30-day mortality after HSCT. Most bloodstream infections were also discovered to be related to CVC. In this setting, antimicrobial resistance and infection control would contribute significantly to the survival of HSCT patients.