{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:27:55Z","timestamp":1760189275406},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,12,20]],"date-time":"2012-12-20T00:00:00Z","timestamp":1355961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Immunoglobulin light chain (<jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content>) amyloidosis can be treated with high\u2010dose melphalan and autologous stem cell transplantation (<jats:styled-content style=\"fixed-case\">HDM<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>). Risk factors for infections may include hyposplenism, hypogammaglobulinemia, treatment\u2010related neutropenia, melphalan\u2010induced mucositis, and nosocomial exposures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and design<\/jats:title><jats:p>A review of 493 patients with <jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content> amyloidosis undergoing treatment with <jats:styled-content style=\"fixed-case\">HDM<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> from <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ugust 1994 to <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ugust 2009 was performed. The objectives were to determine the rate and types of infections following <jats:styled-content style=\"fixed-case\">HDM<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>, to identify factors associated with microbiologically documented infections, and to assess the contribution of infections to all\u2010cause treatment\u2010related mortality (<jats:styled-content style=\"fixed-case\">TRM<\/jats:styled-content>; defined as deaths within 100\u00a0days of <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Microbiologically documented infections after <jats:styled-content style=\"fixed-case\">HDM<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> occurred in 24% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0119) of patients. <jats:styled-content style=\"fixed-case\">TRM<\/jats:styled-content> was 10% (<jats:italic>n<\/jats:italic>\u00a0=\u00a048) overall, and 21% (<jats:italic>n<\/jats:italic>\u00a0=\u00a025) in patients who had a documented infection. Thus, the relative risk of <jats:styled-content style=\"fixed-case\">TRM<\/jats:styled-content> in a patient with a documented infection was 3.42 (95% confidence interval [CI] 2.02\u20135.79). Infections were caused by gram\u2010positive bacteria in 51%, anaerobic bacteria in 16%, gram\u2010negative bacteria in 13%, and fungi in 9% of cases. Serum creatinine &gt;2\u00a0mg\/dL was associated with increased risk of post\u2010<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> infection (38% vs. 21%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0007) with an odds ratio of 2.27 (95% CI 1.40\u20133.68). No significant association for infection was found for age, gender, cardiac involvement, prior steroid therapy, dose of melphalan, multiorgan involvement, days to neutrophil engraftment, or dose of <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>34\u00a0+\u00a0 cells infused.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Serum creatinine &gt;2\u00a0mg\/dL is a risk factor for infections in patients with <jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content> amyloidosis undergoing <jats:styled-content style=\"fixed-case\">HDM<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>. The relative risk of <jats:styled-content style=\"fixed-case\">TRM<\/jats:styled-content> in a patient with a documented infection was increased &gt;3\u2010fold. A broad spectrum of infections, similar to that in other <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> patients, is seen in this population in the early post\u2010<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> period.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12037","type":"journal-article","created":{"date-parts":[[2012,12,21]],"date-time":"2012-12-21T23:52:05Z","timestamp":1356133925000},"page":"187-194","source":"Crossref","is-referenced-by-count":5,"title":["Microbiologically documented infections in patients undergoing high\u2010dose melphalan and autologous stem cell transplantation for the treatment of light chain amyloidosis"],"prefix":"10.1111","volume":"15","author":[{"given":"S.","family":"Taimur","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases Boston Medical Center Boston University School of Medicine Boston Massachusetts 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