Scott BL et al. - In a study to determine the impact of neutropenia on the outcome of hematopoietic cell transplantation (HSCT) in pts with myelodysplasia (MDS), it was shown that intensified strategies to prevent infections should be implemented in MDS pts with preexisting neutropenia who undergo HSCT Methods
A retrospective cohort analysis was performed to determine the impact of neutropenia on the outcome of HSCT in pts with MDS
Results
Among 291 consecutive pts, 178 had absolute neutrophil counts (ANCs) <1500/μL and 113 (39%) had ANCs >=1500/μL within 2 weeks before HSCT
Neutropenic pts more often had poor-risk karyotypes (34% vs 12%) and high-risk IPSS scores (37% vs 18%)
After HSCT, the rate of infections caused by Gram-positive bacteria and invasive fungal infections was significantly increased among neutropenic pts, whereas infections caused by Gram-negative bacteria were not affected
Hazards of nonrelapse mortality (NRM), overall mortality, and infection-related mortality were increased in neutropenic pts, whereas relapse, engraftment, and graft-versus-host-disease were not affected
After adjusting for cytogenetic risk and marrow myeloblast percentages, neutropenic pts remained at significant hazard for infection-related mortality, but not for overall mortality or NRM
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