Persistently High Gam Levels Are Associated with Nonrelapse Mortality in HCT Recipients Irrespective of Invasive Aspergillosis: A Prospective Cohort Study

s / Biol Blood Marrow Transplant 19 (2013) S257eS278 S264 Results: One hundred and thirty-four patients were analyzed (59 for allograft and 75 for autograft). Thirty-eight bacterial isolates from blood of 34 patients (25.3%; 20 patients for allograft and 14 for autograft) were reported. Patients with allogenic HSCT had more frequent BSI (odds ratio 2.23, p 1⁄4 0.047) compared to those with autologous HSCT. BSI of autologous HSCT were reported earlier compared to those of allogenic HSCT (mean 12.1 3.4 vs. 26.5 18.5 days, p 1⁄4 0.007). HSCT in patients with AML (p 1⁄4 0.029), no use of antibiotics from conditioning (p 180 days after diagnosis (p 1⁄4 0.035), elevated CRP (p 1⁄4 0.018), lower serum albumin (p1⁄4 0.033), and acute GVHD G2 (p1⁄4 0.015) showed relation to BSI in multivariate analysis. As for 75 patients with autologous HCT, only no antibiotics use (p 1⁄4 0.007) and elevated CRP (p 1⁄4 0.031) were independent risk factors of BSI. BSIs after allograft was more fatal: 7 of 20 patients with allograft (35%) died of BSI whereas only 1 of 14 patients who underwent autologous HSCT expired. Conclusion: Except pre-transplant serum CRP elevation, allogenic and autologous HSCT have different risk factors. BSI with autologous HSCT occurred earlier and showed better clinical outcomes compared to BSI with allograft. Distinctive natures of bacterial infection after HSCT between allogenic and autologous HST should be considered to establish the best defense strategy against BSI.