Infection burden in mismatched unrelated donor hematopoietic cell transplantation: results from the ACCESS trial.
Blood AdvOct 6, 2026
Jeffery J Auletta, Joseph Stanek, Stephanie Bo-Subait et al.
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In 30 seconds
The ACCESS trial evaluated infection burden in 268 adult patients undergoing HLA-mismatched unrelated donor hematopoietic cell transplantation (HCT) with posttransplant cyclophosphamide (PTCy) for graft-versus-host disease prophylaxis. The study found a significant infection burden, with 465 recorded infections in 183 patients, and an overall survival rate of 81%. The trial is a Phase II multicenter study.
Key findings
- 68% of patients experienced infections, with 465 CTCAE grade 2 to 5 infections recorded.
- 38% of infections were classified as significant or life-threatening.
- Infection density was highest in the first 30 days post-transplant.
- 7.8% of patients died due to infection.
Why it matters
Understanding the infection burden in patients receiving HCT with PTCy is crucial for clinicians to develop strategies to mitigate these risks, particularly in the early post-transplant period when patients are most vulnerable.