{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T18:59:48Z","timestamp":1770231588773,"version":"3.49.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T00:00:00Z","timestamp":1549411200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007449","name":"Takeda Science Foundation","doi-asserted-by":"publisher","award":["203170700061"],"award-info":[{"award-number":["203170700061"]}],"id":[{"id":"10.13039\/100007449","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Systemic steroid is used to treat various transplant\u2010related complications after allogenic hematopoietic stem cell transplantation (allo\u2010HSCT). However, measures to evaluate its impact on infections are still limited. Hence, we examined the cumulative steroid dose used within 30\u00a0days after transplant as a predictor of future risk of infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 226 patients who underwent their first allo\u2010HSCT at Kyoto University Hospital between 2005 and 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010one patients received transplantation from related donors, 106 received unrelated BMT and 59 received unrelated single\u2010unit CBT. Patients were categorized into three groups according to the cumulative steroid dose in terms of prednisolone: no\u2010steroid group (n\u00a0=\u00a0174), low\u2010dose group (\u22647\u00a0mg\/kg) (n\u00a0=\u00a022) and high\u2010dose group (&gt;7\u00a0mg\/kg) (n\u00a0=\u00a030). In a multivariate analysis, high\u2010dose steroid administration was associated with cytomegalovirus (CMV) antigenemia (HR 1.91, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.037) and bacteremia (HR 2.59, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.053). No impact was found on the occurrence of invasive fungal infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>High\u2010dose cumulative steroid could predict high risks of bacteremia and CMV antigenemia. Additional anti\u2010bacterial agents for fever and regular measurement of CMV antigen are recommended for whom with systemic steroid administration even after neutrophil engraftment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13049","type":"journal-article","created":{"date-parts":[[2019,1,18]],"date-time":"2019-01-18T04:55:23Z","timestamp":1547787323000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Impact of cumulative steroid dose on infectious diseases after allogenic hematopoietic stem cell transplantation"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4030-4653","authenticated-orcid":false,"given":"Mizuki","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Hematology and Oncology, Graduate School of Medicine Kyoto University Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6704-3633","authenticated-orcid":false,"given":"Junya","family":"Kanda","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Graduate School of Medicine Kyoto University Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masakatsu","family":"Hishizawa","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Graduate School of Medicine Kyoto University Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadakazu","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Graduate School of Medicine Kyoto University Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kouhei","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Graduate School of Medicine Kyoto University Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akifumi","family":"Takaori\u2010Kondo","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Graduate School of Medicine Kyoto University Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-015-1785-1"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.5966\/sctm.2012-0115"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2014.195"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12398"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2010.80"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2016.09.018"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2008.09.005"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2008.01084.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2013.10.026"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2015.1.220"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2017006429"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1703583"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38210"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.144741"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.82.6.704"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12313"},{"key":"e_1_2_8_18_1","first-page":"825","article-title":"1994 Consensus conference on acute GvHD grading","volume":"15","author":"Przepiorka D","year":"1995","journal-title":"Bone Marrow Transplant"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw326"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ933"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1086\/588660"},{"key":"e_1_2_8_22_1","unstructured":"ISO 14644\u20101 Version 2015.https:\/\/www.iso.org\/standard\/53394.html. 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