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UC increases infection risk in patients undergoing stem cell transplant

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ORLANDO — Patients with ulcerative colitis who underwent hematopoietic stem cell transplant had increased risk for developing opportunistic infection vs. those without ulcerative colitis, according to a poster presentation at Advances in Inflammatory Bowel Disease 2015.

In this cross-sectional study, Maneesh Dave, MD, MPH, of the division of gastroenterology & liver disease, University Hospitals & Louis Stokes VA Medical Center, Cleveland, and colleagues analyzed data of 50,330 patients from the National Inpatient Sample database (weighted n = 248,878) who underwent hematopoietic stem cell transplant (HSCT) between 1993 and 2012.

“In this study, we sought to investigate whether the higher mortality in UC patients is linked to increased risk of opportunistic infections,” the researchers wrote.

Of these patients, 98 had UC (weighted n = 473) and were matched with patients without UC for age, sex, indication of HSCT, source of stem cells, and other criteria.

Overall, the researchers found that patients with UC who underwent HSCT (30.8%) had higher rates of opportunistic infections (OIs) compared with those without UC (13.6%, P < .0001). In addition, patients with UC (14.4%) had greater inpatient mortality compared with patients without UC (6.2%, P = .002).

The patients with UC and OIs had an overall increased risk for mortality (32%) compared with patients without OIs (8%, P = .0001).

“In the matched sample, UC patients continued to have higher risk of OIs as compared to patients without UC in both allogeneic and autologous transplants,” the researchers wrote.

In patients who underwent autologous transplant, UC patients had increased risk for invasive fungal infections (11.6%) compared with those without UC (1.4%, P = .001). In patients who underwent allogeneic transplant, UC patients had increased risk for tuberculosis (2.4%) compared with those without UC (0%, P < .001), as well as higher cytomegalovirus risk (26.3% vs. 2.6 %, P < .0001).

The researchers concluded: “UC is associated with higher risk of certain OIs in patients undergoing HSCT. These OIs are associated with significantly higher odds of inpatient mortality in UC patients and may explain the increased mortality in UC patients undergoing HSCT.” – by Melinda Stevens

Reference:

Dave M, et al. Abstract P-023. Presented at: Advances in Inflammatory Bowel Diseases; Dec. 10-12, 2015; Orlando, Fla.

Disclosure: Healio/Gastroenterology was unable to confirm relevant financial disclosures at the time of publication.