A study of incidence and characteristics of infections in 476 patients from a single center undergoing autologous blood stem cell transplantation

Noemí Puig, Javier De La Rubia, Isidro Jarque, Miguel Salavert, Pau Montesinos, Jaime Sanz, Guillermo Martín, Guillermo Sanz, Susana Cantero, Ignacio Lorenzo, Miguel A. Sanz

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Infectious complications are a major cause of morbidity and mortality in patients who undergo autologous stem cell transplantation (ASCT). We examined 476 patients with hematologic malignancies (401) or solid tumors (75) who underwent ASCT between February 1990 and May 2005. Anti-infectious prophylaxis consisted of different combinations of ciprofloxacin, cotrimoxazole, fluconazole, aerosolized amphotericin B, acyclovir, and intravenous immunoglobulins. Overall, 454 patients (95%) developed fever in the first 60 days after ASCT. In the majority of patients, initial antibiotic therapy consisted of broad-spectrum β-lactamic with or without amikacin. A glycopeptide was administered as initial therapy in 86 cases. Overall, there were 132 (29%) clinically documented infections (37 pneumonias), 79 (17%) microbiologically documented infections (65 bacteremias), and 243 (54%) fevers of unknown origin. Coagulase-negative staphylococci (18, 25%) and E coli (18, 25%) were the organisms most frequently isolated. The pattern of infection did not change throughout the study except for a significantly higher incidence of bacteremia due to gram-positive bacteria in the first 5 years of the study. Infection-related mortality was 5% (21 cases), with pneumonia the most frequent cause of death. ASCT should be considered a low-risk procedure, although new therapeutic approaches for patients developing severe respiratory infections are still needed.

Original languageEnglish (US)
Pages (from-to)186-192
Number of pages7
JournalInternational journal of hematology
Volume86
Issue number2
DOIs
StatePublished - Aug 1 2007

Keywords

  • Autologous stem cell transplantation
  • Chemoprophylaxis
  • Fluoroquinolones
  • Infectious complications

ASJC Scopus subject areas

  • Hematology

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