Introduction
Methods
Patient characteritics | Treatment regimes |
---|---|
Age at enrollment (years) | |
Median (range) | 7.0 years (1.2–18.8) |
Gender | |
Boys | 7 (50%) |
Girls | 7 (50%) |
Race | |
African American | 5 (36%) |
White | 9 (64%) |
Diagnosis | |
Malignant | 7 (50%) |
Non-malignant | 7 (50%) |
Donor | 15 total transplants |
Matched related donor | 4 (27%) |
Matched unrelated donor | 9 (60%) |
Cord blood | 2 (13%) |
Preparative regimen | |
Myeloablative | 9 (60%) |
Reduced intensity conditioning | 5 (33%) |
None | 1 (7%) |
GVHD prophylactic regimensa | |
Containing tacrolimus | 12 |
Containing methotrexate | 11 |
Containing systemic corticosteroids | 5 |
Containing mycophenolate mofetil | 3 |
Containing cyclosporine | 2 |
Results
Probiotic therapy | Details of treatments |
---|---|
Median initiation of probiotics | 60 days post-transplant |
(range − 38 to + 251 days) | |
Timing of initiation of probiotics | |
Started prior to transplant | 2 Transplants |
Started < 100 days after transplant | 8 Transplants |
Started > 100 days after transplant | 5 Transplants |
Lactobacillus bacteremia after probiotics initiated | 0 (0%) |
Non-lactobacillus bacteremia | 5/15 (33%) |
Streptococcus oralis | 1 |
Staphylococcus epidermidis | 1 |
Staphylococcus aureus (MSSA)b | 1 |
Escherichia coli | 1 |
Enterobacter cloacae | 1 |
Clostridium difficile infection by day 100 | 8/15 (53%) |
Median day of positive stool antigen | Day + 13 (range 3–55) |
Stool pathogen identified by day 100 | |
Other bacteria | 0/15 |
Norovirus | 2/15 |
Adenovirus | 0/15 |
Ova and parasites | 0/15 |
GVHDa by day 100 | 12/15 (80%) |
GI tract | 7 |
Stage 3 | 1 |
Stage 4 | 4 |
Uncharacterized | 2 |
Skin | 7 |
Stage 2 | 1 |
Stage 3 | 3 |
Uncharacterized | 3 |
Liver | |
Stage 1 | 1 |
Uncharacterized | 3 |
Patient | Day probiotic initiatedb | Day CDI diagnosedb | Day GI aGVHD diagnosedb | Grade of GI aGVHD | Days from CDI/GVHD to probiotic initiationc |
---|---|---|---|---|---|
CDI alone | |||||
1 | + 17 | + 9 | N/A | N/A | 8 |
2 | + 43 | + 3 | N/A | N/A | 40 |
3 | + 53 | + 13 | N/A | N/A | 40 |
GI aGVHD alone | |||||
4 | + 32 | N/A | + 64 | 3 | 32 |
5 | + 91 | N/A | + 14 | 4 | 77 |
CDI + GI aGVHD | |||||
6 | − 1 | + 34 | + 37 | 4 | 35 |
7 | + 60 | + 55 | + 43 | 4 | 17 |