Avaliação da prevalência da doença do enxerto contra o hospedeiro aguda em pacientes submetidos a transplante alogênico de células tronco hematopoéticas e sua relação com infecção da corrente sanguínea precoce em um Hospital Universitário de Belo Horizonte - 2011 a 2016

Abstract

Despite the notable advances in the immunosuppressive regimens used in allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the past few decades, acute graft-versus-host disease (aGVHD) is still a major complication of this procedure, with considerable associated morbidity and mortality. This was a retrospective study which aimed at analysing the possible causative factors underlying aGVHD and their relationship with blood stream infection (BSI) in adults undergoing allo-HSCT at a public university hospital in Minas Gerais, Brazil, between 2011 and 2016. A total of 94 patients were included, with a median age of 35.5 years (18-65) and a predominance of males (61.7%). Allo-HSCT from a related donor comprised 81.9% of all cases, and peripheral blood stem cells were the main source (81.9%). Among all patients, failure of neutrophil engraftment was observed in 11.7%, any grade mucositis in 91.4% (34% grade II), and death within 100 days post-transplant in 22.3%. The main cause of death was sepsis, and BSI was noted in 45.7% of cases, of which 45.6% were due to Gram-negative bacteria, a higher rate than that observed in developed countries. Empiric antimicrobial therapy was appropriate in most of the cases (64.9%). Approximately a third (34%) of all patients were diagnosed with aGVHD (71.8% grade II), with the most affected site being the gut. In this study, no association was found between BSI and aGVHD, which might be explained by the relatively small sample size of the population studied.