{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T12:10:28Z","timestamp":1790511028276,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T00:00:00Z","timestamp":1617926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005189","name":"Leukemia and Lymphoma Society","doi-asserted-by":"publisher","award":["2315\u201017"],"award-info":[{"award-number":["2315\u201017"]}],"id":[{"id":"10.13039\/100005189","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01 HL150069"],"award-info":[{"award-number":["R01 HL150069"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is a paucity of studies describing the incidence and risk factors for late\u2010occurring (\u22651\u00a0year) infectious complications in contemporary survivors of hematopoietic cell transplantation (HCT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of 641 1\u2010year survivors of HCT, transplanted between 2010 and 2013 as adults, and in remission from their primary disease. Standardized definitions were used to characterize viral, fungal, and bacterial infections. Cumulative incidence of infections was calculated, with relapse\/progression considered as a competing risk event. Fine\u2010Gray subdistribution hazard ratio estimates and 95% confidence intervals (CI) were obtained, adjusted for relevant covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median age at HCT was 55.2\u00a0years (range 18.1\u201378.1\u00a0years); 54.0% were survivors of allogeneic HCT. The 5\u2010year cumulative incidence of a late\u2010occurring infection for the entire cohort was 31.6%; the incidence of polymicrobial (\u22652) infections was 10.1%. In survivors who developed at least one infection, the 5\u2010year incidence of a subsequent infection was 45.3%. Among allogeneic HCT survivors, patients with acute lymphoblastic (HR\u00a0=\u00a01.82 95% CI [1.12\u20132.96]) or myeloid (HR\u00a0=\u00a01.50 95% CI [1.02\u20132.20]) leukemia, and those with an elevated HCT\u2010Comorbidity index score (HR\u00a0=\u00a01.09 95% CI [1.01\u20131.17]) were more likely to develop late\u2010occurring infections; there was an incremental risk associated with severity of graft versus host disease (GVHD) at 1\u2010year post\u2010HCT (mild: HR\u00a0=\u00a02.17, 95% CI [1.09\u20134.33]; moderate\/severe: HR\u00a0=\u00a03.78, 95% CI [1.90\u20137.53]; reference: no GVHD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The burden of late\u2010occurring infections in HCT survivors is substantial, and there are important patient\u2010 and HCT\u2010related modifiers of risk over time. These findings may help guide personalized screening and prevention strategies to improve outcomes after HCT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.3896","type":"journal-article","created":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T12:59:02Z","timestamp":1617973142000},"page":"2956-2966","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Late\u2010occurring infections in a contemporary cohort of hematopoietic cell transplantation survivors"],"prefix":"10.1002","volume":"10","author":[{"given":"Andrew","family":"Sy","sequence":"first","affiliation":[{"name":"Department of Pediatrics Lurie Children\u2019s Hospital of Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9946-8812","authenticated-orcid":false,"given":"Dayana","family":"Chanson","sequence":"additional","affiliation":[{"name":"Department of Population Sciences City of Hope Duarte CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Berano Teh","sequence":"additional","affiliation":[{"name":"Department of Population Sciences City of Hope Duarte CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence L.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Population Sciences City of Hope Duarte CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryotaro","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Hematology &amp; Hematopoietic Cell Transplantation City of Hope Duarte CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeet","family":"Dadwal","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases City of Hope Duarte CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2604-8603","authenticated-orcid":false,"given":"Saro H.","family":"Armenian","sequence":"additional","affiliation":[{"name":"Department of Population Sciences City of Hope Duarte CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2013.07.020"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-04-348730"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.12.674"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.33.7212"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djaa022"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2012.311"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-03-082933"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-01-0035"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2016.10.001"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-018-0401-4"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.09.031"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.07.025"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/bbmt.2002.v8.pm12374456"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2014.03.004"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0b013e328353bc7d"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.17.7428"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2010.02.021"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-06-358226"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djy231"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2014.12.001"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000168253.91200.83"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1086\/588660"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1214\/aos\/1176350951"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1262-8"},{"key":"e_1_2_9_26_1","first-page":"947","article-title":"Lung\u2010cancer mortality as related to residence and smoking histories. 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