Fevers post infusion of T-cell replete hla mismatched haploidentical hematopoietic stem cells with post-transplant cyclophosphamide: risk factors and impact on transplant outcomes

• Published in: Bone marrow transplantation (Basingstoke) 2019-11, Vol.54 (11), p.1756-1763
• Main Authors: Solh, Melhem M., Dickhaus, Elizabeth, Solomon, Scott R., Morris, Lawrence E., Zhang, Xu, Holland, H. Kent, Bashey, Asad
• Format: Article
• Language: English
• Subjects: 692/1807/1490; 692/499; Adult; Aged; Allografts; Blood diseases; CD3 antigen; CD34 antigen; Cell Biology; Cyclophosphamide; Drug therapy; Female; Fever; Fever - blood; Fever - epidemiology; Fever - etiology; Graft-versus-host reaction; Grafts; Hematology; Hematopoietic stem cells; Histocompatibility antigen HLA; HLA Antigens; Humans; Internal Medicine; Lymphocyte Depletion; Lymphocytes T; Male; Medicine; Medicine & Public Health; Middle Aged; Morbidity; Mortality; Peripheral Blood Stem Cell Transplantation; Public Health; Regression analysis; Retrospective Studies; Risk analysis; Risk Factors; Stem cell transplantation; Stem Cells; T cells; T-Lymphocytes; Transplantation; Transplants & implants
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/s41409-019-0522-4

Fever is a common early complication after infusion of stem cells in patients undergoing T-replete HLA haploidentical transplantation using post-transplant cyclophosphamide (PTCY). We analyzed the records of 172 haploidentical transplant patients to identify risk factors and to assess the impact of such fevers on transplant morbidity and mortality. One hundred and seventy-two patients received haploidential hematopoietic stem cell transplantation (haplo-HSCT) using PBSC ( n  = 103) or marrow ( n  = 69) grafts. One hundred and forty patients (81%) experienced fever ( T  ≥ 100.5 °F or >38 °C) with median onset on d + 2. Compared to patients who did not develop fevers, patients with fevers received higher median CD34+ cell dose (5.00 vs. 3.08 × 10 6 /kg, p