Impact of Clostridioides difficile infection on the outcome of patients receiving a hematopoietic stem cell transplantation

• Main Authors: Sarah Weber, Sebastian Scheich, Aaron Magh, Sebastian Wolf, Julius C. Enßle, Uta Brunnberg, Claudia Reinheimer, Thomas A. Wichelhaus, Volkhard A.J. Kempf, Johanna Kessel, Maria J.G.T. Vehreschild, Hubert Serve, Gesine Bug, Björn Steffen, Michael Hogardt
• Format: Article
• Language: English
• Published: Elsevier 2020-10-01
• Series: International Journal of Infectious Diseases
• Subjects: Clostridioides difficile; diarrhea; hematopoietic stem cell transplantation; acute myeloid leukemia; lymphoma
• Online Access: http://www.sciencedirect.com/science/article/pii/S1201971220306597

Objectives: Clostridioides difficile infections (CDI) are common in autologous (auto-HSCT) or allogenic hematopoietic stem cell transplant (allo-HSCT) recipients. However, the impact of CDI on patient outcomes is controversial. We conducted this study to examine the impact of CDI on patient outcomes. Methods: We performed a retrospective single-center study, including 191 lymphoma patients receiving an auto-HSCT and 276 acute myeloid leukemia (AML) patients receiving an allo-HSCT. The primary endpoint was overall survival (OS). Secondary endpoints were causes of death and, for the allo-HSCT cohort, GvHD- and relapse-free survival (GRFS). Results: The prevalence of CDI was 17.6% in the AML allo-HSCT and 7.3% in the lymphoma auto-HSCT cohort. A higher prevalence of bloodstream infections, but no differences concerning OS or cause of death were found for patients with CDI in the auto-HSCT cohort. [AU] In the allo-HSCT cohort, OS and GRFS were similar between CDI and non-CDI patients. However, the leading cause of death was relapse among non-CDI patients, but it was infectious diseases in the CDI group with fewer deaths due to relapse. Conclusions: CDI was not associated with worse survival in patients receiving a hematopoietic stem cell transplantation, and there were even fewer relapse-related deaths in the AML allo-HSCT cohort.