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Kamel NA, Abdalla MS, Al Ali A, Alshahrani MY, Aboshanab KM, El Borhamy MI. Effectiveness of Pre-Transplant Screening for High-Priority Multidrug-Resistant Pathogens on Pre-Engraftment Infections After Hematopoietic Stem Cell Transplantation. Infect Drug Resist 2024; 17:2249-2260. [PMID: 38854781 PMCID: PMC11162205 DOI: 10.2147/idr.s463868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/26/2024] [Indexed: 06/11/2024] Open
Abstract
Objective Owing to the rising incidence of multidrug-resistant organisms (MDRO) and the high mortality rates associated with such bacterial infections post-hematopoietic stem cell transplantation (HSCT), we investigated the MDRO colonization rate prior to transplantation using an active surveillance approach and determined its impact on subsequent infection during the pre-engraftment period. Methods A single-center observational study was conducted, and surveillance cultures from multiple body sites, including the rectum, nasal cavity, and groin, were performed at admission to determine MDRO colonization. Serological tests were used to detect certain viruses and toxoplasmosis before HSCT. Results In the pre-transplant setting, 59 MDRO were recovered from the 40 HSCT recipients. Of the 59 isolates recovered from one or more body sites, 29 were positive for methicillin-resistant Staphylococcus aureus (MRSA), 7 for carbapenem-resistant Enterobacterales (CRE), and 23 were positive for extended-spectrum β-lactamase (ESBLs). Serological assessment before HSCT revealed active or reactivation of latent infection with cytomegalovirus (7.5%), Epstein-Barr virus (EBV; 5%), and Toxoplasma gondii (2.5%) among HSCT patients. In terms of factors associated with pre-engraftment infections, the type of transplant (p=0.04) was statistically significant, whereas other factors, such as age, sex, and underlying conditions, were not. In post-transplant settings, bloodstream infections (BSIs) were documented in 2 allogeneic HSCT patients (5%), and the isolated microorganisms were ESBL-producing E. coli and non-MDR Acinetobacter baumannii. Conclusion Active screening cultures are a helpful tool for identifying patients colonized by MDRO or relevant viruses before HSCT, and for predicting those at risk of developing subsequent pre-engraftment infections. Additionally, active screening may aid in predicting those who are likely to develop subsequent pre-engraftment infections Our findings highlight the importance of pre-transplant screening for high-priority multidrug-resistant pathogens and the application of infection control interventions after HSCT.
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Affiliation(s)
- Noha A Kamel
- Department of Microbiology, Faculty of Pharmacy, Misr International University (MIU), Cairo, Egypt
| | - Mahmoud S Abdalla
- Hematology and Bone Marrow Transportation (BMT) Unit, International Medical Center (IMC), Cairo, Egypt
| | - Amer Al Ali
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, University of Bisha, Bisha, 67714, Saudi Arabia
| | - Mohammad Y Alshahrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 9088, Saudi Arabia
| | - Khaled M Aboshanab
- Microbiology and Immunology Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
- Department of Pharmaceutical Life Sciences, Faculty of Pharmacy, University Technology MARA (Uitm), Campus Puncak Alam, Bandar Puncak Alam, Selangor, 42300, Malaysia
| | - Mervat I El Borhamy
- Department of Microbiology, Faculty of Pharmacy, Misr International University (MIU), Cairo, Egypt
- International Medical Center, Clinical Microbiology Laboratory, Cairo, Egypt
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Akhmedov M, Klyasova G, Kuzmina L, Fedorova A, Drokov M, Parovichnikova E. Impact of fluoroquinolone administration and gut mucosal colonization on the risk of pre-engraftment bloodstream infections after allogeneic hematopoietic cell transplantation. Leuk Lymphoma 2023; 64:1102-1111. [PMID: 37086466 DOI: 10.1080/10428194.2023.2197532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 04/24/2023]
Abstract
Fluoroquinolones (FQ) has been used after allogeneic hematopoietic stem cell transplantation (allo-HCT) for decades. This study on 284 allo-HCT recipients aimed to analyze the impact of FQ on pre-engraftment BSI. A total of 154 patients were colonized with resistant gram-negative bacteria, and 130 patients were not. Colonized patients did not receive FQ (n = 147) except 7 who received FQ as sequential therapy; 98 non-colonized patients received FQ, whereas 32 did not. Gram-negative (p < 0.0001), and ESBL-E BSI (p < 0.0001) were higher in colonized patients receiving FQ. No difference was found in gram-positive BSI (p = 0.452). In multivariate analysis colonized patients with (p < 0.0001) or without FQ (p = 0.007), omission of FQ in non-colonized patients (p = 0.038), and active disease (p = 0.042) were associated with gram-negative BSI, whereas mismatched unrelated donor transplantations - with gram-positive BSI (p = 0.009). Colonized patients with FQ have a higher risk of gram-negative BSI. In non-colonized patients, FQ prophylaxis is effective approach significantly reducing gram-negative BSI risk.
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Majumdar A, Shah MR, Park JJ, Narayanan N, Kaye KS, Bhatt PJ. Challenges and Opportunities in Antimicrobial Stewardship among Hematopoietic Stem Cell Transplant and Oncology Patients. Antibiotics (Basel) 2023; 12:antibiotics12030592. [PMID: 36978459 PMCID: PMC10044884 DOI: 10.3390/antibiotics12030592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
Antimicrobial stewardship programs play a critical role in optimizing the use of antimicrobials against pathogens in the era of growing multi-drug resistance. However, implementation of antimicrobial stewardship programs among the hematopoietic stem cell transplant and oncology populations has posed challenges due to multiple risk factors in the host populations and the infections that affect them. The consideration of underlying immunosuppression and a higher risk for poor outcomes have shaped therapeutic decisions for these patients. In this multidisciplinary perspective piece, we provide a summary of the current landscape of antimicrobial stewardship, unique challenges, and opportunities for unmet needs in these patient populations.
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Affiliation(s)
- Anjali Majumdar
- Division of Allergy and Infectious Disease, Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
- Correspondence:
| | - Mansi R. Shah
- Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | | | - Navaneeth Narayanan
- Division of Allergy and Infectious Disease, Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
- Rutgers-Ernest Mario School of Pharmacy, Piscataway, NJ 08854, USA
| | - Keith S. Kaye
- Division of Allergy and Infectious Disease, Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | - Pinki J. Bhatt
- Division of Allergy and Infectious Disease, Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
- Rutgers-Ernest Mario School of Pharmacy, Piscataway, NJ 08854, USA
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4
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Malagola M, Turra A, Signorini L, Corbellini S, Polverelli N, Masina L, Del Fabro G, Lorenzotti S, Fumarola B, Farina M, Morello E, Radici V, Buttini EA, Colnaghi F, Bernardi S, Re F, Caruso A, Castelli F, Russo D. Results of an Innovative Program for Surveillance, Prophylaxis, and Treatment of Infectious Complications Following Allogeneic Stem Cell Transplantation in Hematological Malignancies (BATMO Protocol). Front Oncol 2022; 12:874117. [PMID: 35785189 PMCID: PMC9247274 DOI: 10.3389/fonc.2022.874117] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background Infectious complications are a significant cause of morbidity and mortality in patients undergoing allogeneic haematopoietic stem cell transplantation (Allo-SCT). The BATMO (Best-Antimicrobial-Therapy-TMO) is an innovative program for infection prevention and management and has been used in our centre since 2019. The specific features of the BATMO protocol regard both prophylaxis during neutropenia (abandonment of fluoroquinolone, posaconazole use in high-risk patients, aerosolized liposomal amphotericin B use until engraftment or a need for antifungal treatment, and letermovir use in CMV-positive recipients from day 0 to day +100) and therapy (empirical antibiotics based on patient clinical history and colonization, new antibiotics used in second-line according to antibiogram with the exception of carbapenemase-producing K pneumoniae for which the use in first-line therapy is chosen). Methods Data on the infectious complications of 116 transplant patients before BATMO protocol (Cohort A; 2016 - 2018) were compared to those of 84 transplant patients following the introduction of the BATMO protocol (Cohort B; 2019 - 2021). The clinical and transplant characteristics of the 2 Cohorts were comparable, even though patients in Cohort B were at a higher risk of developing bacterial, fungal, and CMV infections, due to a significantly higher proportion of myeloablative regimens and haploidentical donors. Results No change in the incidence of infections with organ localization was observed between the two Cohorts. A significant reduction in Clostridioides difficile infections by day +100 was observed in Cohort B (47% vs. 15%; p=0.04). At day +30, a higher incidence of Gram-negative bloodstream infections (BSIs) was observed in Cohort B (12% vs. 23%; p=0.05). By day +100 and between days +100 and +180, the incidence of BSIs and of the various etiological agents, the mortality from Gram-negative bacteria, and the incidence of invasive fungal infections were not different in the two Cohorts. The incidence of CMV reactivations by day +100 dropped drastically in patients of Cohort B, following letermovir registration (51% vs. 15%; p=0.00001). Discussion The results of this study suggest that the BATMO program is safe. In particular, the choice to avoid prophylaxis with fluoroquinolone was associated with an increase in Gram-negative BSIs by day +30, but this did not translate into higher levels of mortality. Moreover, this strategy was associated with a significant reduction of Clostridiodes difficile infections. The efficacy of anti-CMV prophylaxis with letermovir was confirmed by a significant reduction in CMV reactivations. Even though patients in Cohort B were at higher risk of developing fungal infections (more haploidentical transplants with more myeloablative regimens), the extensive use of posaconazole for prophylaxis balanced this risk, and no increase in the incidence of fungal-associated complications was observed.
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Affiliation(s)
- Michele Malagola
- Chair of Hematology, Bone Marrow Transplant Unit, ASST-Spedali Civili Brescia, Depatment of Clinical and Experimental Sciences University of Brescia, Brescia, Italy
- *Correspondence: Michele Malagola,
| | - Alessandro Turra
- Chair of Hematology, Bone Marrow Transplant Unit, ASST-Spedali Civili Brescia, Depatment of Clinical and Experimental Sciences University of Brescia, Brescia, Italy
| | - Liana Signorini
- Department of Infectious and Tropical Diseases, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | - Silvia Corbellini
- Department of Molecular and Translational Medicine, Section of Microbiology and Virology, University of Brescia Medical School, Brescia, Italy
| | - Nicola Polverelli
- Chair of Hematology, Bone Marrow Transplant Unit, ASST-Spedali Civili Brescia, Depatment of Clinical and Experimental Sciences University of Brescia, Brescia, Italy
| | - Lorenzo Masina
- Chair of Hematology, Bone Marrow Transplant Unit, ASST-Spedali Civili Brescia, Depatment of Clinical and Experimental Sciences University of Brescia, Brescia, Italy
| | - Giovanni Del Fabro
- Department of Infectious and Tropical Diseases, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | - Silvia Lorenzotti
- Department of Infectious and Tropical Diseases, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | - Benedetta Fumarola
- Department of Infectious and Tropical Diseases, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | - Mirko Farina
- Chair of Hematology, Bone Marrow Transplant Unit, ASST-Spedali Civili Brescia, Depatment of Clinical and Experimental Sciences University of Brescia, Brescia, Italy
| | - Enrico Morello
- Chair of Hematology, Bone Marrow Transplant Unit, ASST-Spedali Civili Brescia, Depatment of Clinical and Experimental Sciences University of Brescia, Brescia, Italy
| | - Vera Radici
- Chair of Hematology, Bone Marrow Transplant Unit, ASST-Spedali Civili Brescia, Depatment of Clinical and Experimental Sciences University of Brescia, Brescia, Italy
| | - Eugenia Accorsi Buttini
- Chair of Hematology, Bone Marrow Transplant Unit, ASST-Spedali Civili Brescia, Depatment of Clinical and Experimental Sciences University of Brescia, Brescia, Italy
| | - Federica Colnaghi
- Chair of Hematology, Bone Marrow Transplant Unit, ASST-Spedali Civili Brescia, Depatment of Clinical and Experimental Sciences University of Brescia, Brescia, Italy
| | - Simona Bernardi
- Chair of Hematology, Bone Marrow Transplant Unit, ASST-Spedali Civili Brescia, Depatment of Clinical and Experimental Sciences University of Brescia, Brescia, Italy
- Centro di Ricerca Ematologico – Associazione Italiana per la Lotta alle Leucemie, Linfomi e Mieloma (AIL), Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili di Brecia, Brescia, Italy
| | - Federica Re
- Chair of Hematology, Bone Marrow Transplant Unit, ASST-Spedali Civili Brescia, Depatment of Clinical and Experimental Sciences University of Brescia, Brescia, Italy
- Centro di Ricerca Ematologico – Associazione Italiana per la Lotta alle Leucemie, Linfomi e Mieloma (AIL), Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili di Brecia, Brescia, Italy
| | - Arnaldo Caruso
- Department of Molecular and Translational Medicine, Section of Microbiology and Virology, University of Brescia Medical School, Brescia, Italy
| | - Francesco Castelli
- Department of Infectious and Tropical Diseases, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | - Domenico Russo
- Chair of Hematology, Bone Marrow Transplant Unit, ASST-Spedali Civili Brescia, Depatment of Clinical and Experimental Sciences University of Brescia, Brescia, Italy
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Clinical Manifestations of Pulmonary Mucormycosis in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation: A 21-Case Series Report and Literature Review. Can Respir J 2022; 2022:1237125. [PMID: 35692949 PMCID: PMC9184213 DOI: 10.1155/2022/1237125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Mucormycosis is a rare, invasive disease caused by opportunistic pathogens related to the Mucorales order with high fatality rates in immunocompromised hosts, especially in recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Diagnosis and treatment of pulmonary mucormycosis in recipients of allo-HSCT remains challenging. Purpose The aim of this study is to summarize and analyze the clinical features of pulmonary mucormycosis in recipients of allo-HSCT to explore further clinical research directions for this rare fungal infection in the particular populations. Methods We retrospectively reviewed pulmonary mucormycosis in patients who received allo-HSCT in our hospital from January 2010 to December 2020. A total of 21 patients fulfilled the diagnostic criteria for pulmonary mucormycosis according to the European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/MSG) criteria. Demographic and clinical data, mycological and histopathological records, and treatment and prognosis data were collected. Clinical variables were compared between survivors and nonsurvivors. The survival days of patients with and without graft-versus-host disease (GVHD) and hemoptysis were compared separately. Results Most of the recipients of allo-HSCT were male patients with a mean age of 43 years. Acute myeloid leukemia (AML) was the most common primary hematologic malignancy. Extrapulmonary involvement accounted for 28.6%, of the cases, including central nervous system (n = 5) and skin and soft tissue (n = 1). The median time to infection was 96 days after allo-HSCT. Clinical presentations were nonspecific, including fever (76.2%) and cough (85.7%), as well as dyspnea (19.0%), chest pain (38.1%), and hemoptysis (61.9%). Ground-glass infiltrates (95.0%) and nodules/masses (80%) were the most common radiographic patterns on chest CT. The most common pathogen was Rhizopus (63.2%), and breakthrough infection accounted for 90.5%. Fifteen of the patients died within one year, and the median time from diagnosis to death was 47 days. Conclusion Mucormycosis is a fatal infection disease. Opportunistic infections in recipients of allo-HSCT are mainly breakthrough infections and may have a seasonal distribution (summer and autumn) and more cases of death in autumn. The marked reversed halo sign can be seen both in the initial stage of infection and after antifungal treatment. In our case series, patients with pulmonary mucormycosis with extrapulmonary involvement 100% died within one year. There are more patients with GVHD before infection and hemoptysis in nonsurvivors than survivors within 100 days. Patients with GVHD before infection and hemoptysis have a shorter survival time than those without.
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6
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Liu E, Lv S, Yi P, Feng L, Deng X, Xia H, Xu Y. Central nervous system infection with Seoul Orthohantavirus in a child after hematopoietic stem cell transplantation: a case report. Virol J 2022; 19:75. [PMID: 35459229 PMCID: PMC9034594 DOI: 10.1186/s12985-022-01766-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/21/2022] [Indexed: 12/03/2022] Open
Abstract
Background Patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT) are prone to complicate viral infection. Central nervous system (CNS) involvement caused by the viruses is rare but with poor prognosis. Hantavirus, which usually cause hemorrhagic fever with renal syndrome (HFRS), and none case has been reported about these infection in allo-HSCT patients. Case presentation In August 2021, a 13-year-old male child developed intermittent fever and refractory hypotension after allo-HSCT. Magnetic resonance imaging of the head revealed abnormal signal foci in the left midbrain cerebral peduncle and bilateral thalamus. His family reported traces of mouse activity in the patient’s home kitchen. HFRS was suspected, but with no significant kidney damage. The specific immunoglobulin (Ig) G and M of hantavirus were negative. The metagenomic next-generation sequencing (mNGS) detected Seoul Orthohantavirus (SEOV) sequences directly in cerebrospinal fluid and blood. Conclusions Allo-HSCT patients are a high-risk group for infection. Usually the causative agent of infection is difficult to determine, and sometimes the site of infection is concealed. This report highlights the importance of suspecting hantavirus infection in allo-HSCT patients with CNS symptoms despite the absence of renal syndromes. The mNGS is a powerful tool for detecting pathogens. CNS infection with Seoul orthohantavirus in transplant patients is rare but possible as demonstrated in this case. To the best of our knowledge, this is the first reported case employing mNGS to diagnose SEOV caused CNS infection in an allo-HSCT patient. Supplementary Information The online version contains supplementary material available at 10.1186/s12985-022-01766-6.
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Affiliation(s)
- Enyi Liu
- Department of Hematology, XiangYa Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shuhe Lv
- Department of Pharmacy, XiangYa Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Panpan Yi
- Department of Infectious Diseases, XiangYa Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Li Feng
- Department of Neurology, XiangYa Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaolu Deng
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Han Xia
- Department of Scientific Affaires, Hugobiotech Co., Ltd., Beijing, China
| | - Yajing Xu
- Department of Hematology, XiangYa Hospital, Central South University, Changsha, Hunan, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China. .,Hunan Blood Tumor Clinical Medical Research Center, Changsha, Hunan, China.
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7
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Jacobsen M, Rottmann P, Dembek TA, Gerke AL, Gholamipoor R, Blum C, Hartmann NU, Verket M, Kaivers J, Jäger P, Baermann BN, Heinemann L, Marx N, Müller-Wieland D, Kollmann M, Seyfarth M, Kobbe G. Feasibility of Wearable-Based Remote Monitoring in Patients During Intensive Treatment for Aggressive Hematologic Malignancies. JCO Clin Cancer Inform 2022; 6:e2100126. [PMID: 35025669 DOI: 10.1200/cci.21.00126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Intensive treatment protocols for aggressive hematologic malignancies harbor a high risk of serious clinical complications, such as infections. Current techniques of monitoring vital signs to detect such complications are cumbersome and often fail to diagnose them early. Continuous monitoring of vital signs and physical activity by means of an upper arm medical wearable allowing 24/7 streaming of such parameters may be a promising alternative. METHODS This single-arm, single-center observational trial evaluated symptom-related patient-reported outcomes and feasibility of a wearable-based remote patient monitoring. All wearable data were reviewed retrospectively and were not available to the patient or clinical staff. A total of 79 patients (54 inpatients and 25 outpatients) participated and received standard-of-care treatment for a hematologic malignancy. In addition, the wearable was continuously worn and self-managed by the patient to record multiple parameters such as heart rate, oxygen saturation, and physical activity. RESULTS Fifty-one patients (94.4%) in the inpatient cohort and 16 (64.0%) in the outpatient cohort reported gastrointestinal symptoms (diarrhea, nausea, and emesis), pain, dyspnea, or shivering in at least one visit. With the wearable, vital signs and physical activity were recorded for a total of 1,304.8 days. Recordings accounted for 78.0% (63.0-88.5; median [interquartile range]) of the potential recording time for the inpatient cohort and 84.6% (76.3-90.2) for the outpatient cohort. Adherence to the wearable was comparable in both cohorts, but decreased moderately over time during the trial. CONCLUSION A high adherence to the wearable was observed in patients on intensive treatment protocols for a hematologic malignancy who experience high symptom burden. Remote patient monitoring of vital signs and physical activity was demonstrated to be feasible and of primarily sufficient quality.
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Affiliation(s)
- Malte Jacobsen
- Faculty of Health, University Witten/Herdecke, Witten, Germany.,Department of Internal Medicine I, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Pauline Rottmann
- Department of Hematology, Oncology, and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany.,Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Till A Dembek
- Department of Neurology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Anna L Gerke
- Department of Hematology, Oncology, and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany.,Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Rahil Gholamipoor
- Department of Computer Science, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Christopher Blum
- Department of Biology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Niels-Ulrik Hartmann
- Department of Internal Medicine I, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Marlo Verket
- Department of Internal Medicine I, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Jennifer Kaivers
- Department of Hematology, Oncology, and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany.,Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Paul Jäger
- Department of Hematology, Oncology, and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany.,Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Ben-Niklas Baermann
- Department of Hematology, Oncology, and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany.,Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | | | - Nikolaus Marx
- Department of Internal Medicine I, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Dirk Müller-Wieland
- Department of Internal Medicine I, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Markus Kollmann
- Department of Biology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Melchior Seyfarth
- Faculty of Health, University Witten/Herdecke, Witten, Germany.,Department of Cardiology, Helios University Hospital of Wuppertal, Wuppertal, Germany
| | - Guido Kobbe
- Department of Hematology, Oncology, and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany.,Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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