Severe Acute Graft-Versus-Host Disease Increases The Incidence of Blood Stream Infection and Mortality After Allogeneic Hematopoietic Cell Transplantation: Japanese Transplant Registry Study

A study recently published in Bone Marrow Transplantation has found a correlation between blood stream infection (BSI) and acute Graft Versus Host Disease (aGVHD) in patients following allogeneic hematopoietic cell transplantation (allo-HCT). This retrospective analysis study was conducted by the Transplant Complications Working Group of The Japan Society for Hematopoietic Cell Transplantation on 11,098 Japanese patients.

Approved for the treatment of certain hematological malignancies, allo-HCT is a treatment which involves transplanting hematopoietic stem cells. Unfortunately, aGVHD, where the transplanted cells attack the recipient, and BSIs are complications which can arise after allo-HCT. Although several risk factors have been established for BSI and allo-HCT, the relationship between BSI and aGVHD remains poorly understood. The aim of this study was to determine BSI risk factors and aGVHD. 

Following allo-HSCT, 2,172 patients developed BSI, with the highest rate of BSI observed in patients who had developed severe aGVHD post transplantation. Among all infections, the most prevalent were from gram-positive cocci, with the highest mortality rates being from fungal or gram-negative rod BSI. Severe aGVHD in allo-HCT patients was associated with increases in both the incidence of BSI and the overall mortality after BSI onset. This study provides important evidence for the monitoring and prevention of BSI after allo-HCT.


Inoue, Y., Okinaka, K., Fuji, S. et al. Severe acute graft-versus-host disease increases the incidence of blood stream infection and mortality after allogeneic hematopoietic cell transplantation: Japanese transplant registry study. Bone Marrow Transplant (2021). https://doi.org/10.1038/s41409-021-01291-0

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