{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T07:13:11Z","timestamp":1776755591346,"version":"3.51.2"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,6,1]],"date-time":"2019-06-01T00:00:00Z","timestamp":1559347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The spectrum of infectious complications in autologous hematopoietic cell transplant recipients (AHCT) with multiple myeloma has not been well described in the recent era of novel agent induction and improved supportive care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study of 413 adult myeloma AHCT recipients at our institution from 2007\u20102016 to describe the cumulative incidence and risk factors for various infections and FN occurring within the first 100\u00a0days after AHCT. Additionally, landmark analysis was done among 404 patients who survived at least 100\u00a0days after transplant admission to estimate the association of infections with subsequent non\u2010relapse mortality (NRM), overall survival (OS), and relapse\u2010free survival (RFS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cumulative incidences (95% CI) of infection events by day 100 were: FN 43% (38\u201048), any infection 21% (17\u201025), bacterial 17% (14\u201021), viral 4% (3\u20107) and fungal 1% (0.5\u20103), central line\u2010associated blood stream infection 3% (2\u20106), and <jats:italic>Clostridium difficile<\/jats:italic> colitis 6% (4\u20108). Patients with infection had a longer initial transplant hospitalization (median 17 vs 16\u00a0days, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01), more readmissions (31% vs 8%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01), and spent more days in hospital in first 100\u00a0days (median 18 vs 16\u00a0days, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). A 100\u2010day mortality was low and similar between groups (2% vs 1%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.28). In landmark analysis of 404 100\u2010day survivors, OS was worse among patients with early infections (hazard ratio 1.54 [1.03\u20102.30], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03), although there was no difference in NRM and RFS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Notwithstanding advances in supportive care, early infectious complications remain a relevant source of morbidity and require attention in myeloma AHCT recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13114","type":"journal-article","created":{"date-parts":[[2019,5,18]],"date-time":"2019-05-18T16:28:40Z","timestamp":1558196920000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Early infectious complications after autologous hematopoietic cell transplantation for multiple myeloma"],"prefix":"10.1111","volume":"21","author":[{"given":"Shafia","family":"Rahman","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Cleveland Clinic, Fairview Hospital Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Rybicki","sequence":"additional","affiliation":[{"name":"Department of Qualitative Health Sciences Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Betty","family":"Ky Hamilton","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program Taussig Cancer Center, Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brad","family":"Pohlman","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program Taussig Cancer Center, Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepa","family":"Jagadeesh","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program Taussig Cancer Center, Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Cober","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Section of Transplant Infectious Diseases and Transplant Center Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matt","family":"Kalaycio","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program Taussig Cancer Center, Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Dean","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program Taussig Cancer Center, Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"Sobecks","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program Taussig Cancer Center, Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherif B.","family":"Mossad","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Section of Transplant Infectious Diseases and Transplant Center Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Navneet S.","family":"Majhail","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program Taussig Cancer Center, Cleveland Clinic Cleveland 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