Impact of a change in antibacterial prophylaxis on bacteremia and hospitalization rates following outpatient autologous peripheral blood stem cell transplantation for multiple myeloma

Kim, J.H.; Goulston, Claudia; Zangari, Maurizio; Tricot, Guido; Boyer, Michael W.; Hanson, Kimberly E.

doi:10.1111/tid.12225

Cited by 14 publications

(12 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In previous studies of bacteremia in patients with multiple myeloma, Enterococcus spp. were responsible for 5%‐21% of all episodes . Patients with multiple myeloma get sequential rounds of chemotherapy, often requiring prolonged courses of fluoroquinolone prophylaxis during the treatment cycles.…”

Section: Discussionmentioning

confidence: 70%

“…Previous studies done after initiation of routine antimicrobial prophylaxis in ASCTs had described rates of bacteremia ranging from 5% to 20% . However, studies looking at incidence of bacteremia following ASCT for multiple myeloma have reported rates of 13.4%‐15% which is similar to our findings.…”

Section: Discussionmentioning

confidence: 99%

“…were responsible for 5%-21% of all episodes. 9,10 Patients with multiple myeloma get sequential rounds of chemotherapy, often requiring prolonged courses of fluoroquinolone prophylaxis during the treatment cycles. Our center is a referral center for multiple myeloma treatment and the patients have often been heavily pretreated with first and second line therapies before getting treatment at the Myeloma Institute.…”

Section: Gram-positive Organisms Made Up 63% Of Cases Withmentioning

confidence: 99%

See 2 more Smart Citations

Bacteremias following autologous stem cell transplantation for multiple myeloma: Risk factors and outcomes

Mohan¹,

Susanibar-Adaniya²,

Buros³

et al. 2019

Transplant Infectious Dis

View full text Add to dashboard Cite

Background Autologous stem cell transplantation (ASCT) is a commonly used treatment for multiple myeloma (MM). This retrospective cohort study characterizes the risk factors and outcomes associated with bacteremia following ASCT at a single center. Methods We conducted a retrospective analysis in subjects who underwent ASCT for multiple myeloma and other malignancies from May 2014 to March 2015 at a single center. The control cohort included all subjects undergoing ASCT in the same time period who did not develop bacteremia. Results During the study period, 363 ASCTs were completed in 282 discrete patients. Bacteremia was documented in 13% of all transplants. Enterococcus faecium was the most frequent species overall (14/62, 23%). Vancomycin resistance was present in 93% of E faecium isolates. Bacteremia was associated with a significantly decreased survival in patients who received their transplant after the first year of myeloma treatment. Overall survival (OS) was not significantly different in the two cohorts among patients undergoing ASCT within the first year of myeloma treatment. Survival analysis showed a significantly decreased OS in patients who developed Enterococcus bacteremia as compared to the non‐bacteremia cohort. Enterococcal bacteremia was associated with significantly longer duration of neutropenia (mean 14 vs 9.7 days, P = 0.01), hospitalization (mean 61.7 vs 20.4 days, P = 0.0006), and higher mortality (69% vs 25%, P = 0.01) as compared to other bacteremias. Conclusion We found a high incidence of E faecium and a low incidence of MRSA and Pseudomonas bacteremias following ASCT in our patient population. Survival analysis in our cohort suggests that the effect of underlying disease status and cumulative chemotherapy is critically important in determining outcomes related to bacteremia. Enterococcal bacteremias following ASCT were associated with significantly higher morbidity and mortality than non‐enterococcal bacteremias.

show abstract

Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Gram-positive Organisms Made Up 63% Of Cases Withmentioning

confidence: 99%

See 1 more Smart Citation

Bacteremias following autologous stem cell transplantation for multiple myeloma: Risk factors and outcomes

Mohan¹,

Susanibar-Adaniya²,

Buros³

et al. 2019

Transplant Infectious Dis

View full text Add to dashboard Cite

show abstract

“…The risk could, ho be influenced by other factors, as outpatient vs inpatient transplantation se which were not reported in our study. The benefits and potential risks of fluoroquinolone prophylaxis must be carefully assessed, especially in center high fluoroquinolone resistance rates among GNRs [24].…”

Section: Outcomementioning

confidence: 99%

Antimicrobial Resistance in Gram-Negative Rods Causing Bacteremia in Hematopoietic Stem Cell Transplant Recipients: Intercontinental Prospective Study of the Infectious Diseases Working Party of the European Bone Marrow Transplantation Group

Averbuch

Tridello

Hoek

et al. 2017

Clinical Infectious Diseases

211

119

View full text Add to dashboard Cite

show abstract

“…With advancements in AutoHCT such as use of broad spectrum antibiotics, peripheral blood derived hematopoietic stem cell products, improved anti-emetics, and approaches to reduce mucosal toxicity, transplantation has become feasible in an outpatient setting (11–13). Outpatient transplants may offer benefit to patients in terms of enhanced comfort, shorter hospital length of stay, decreased exposure to sick contacts, and decreased costs and resource utilization (9, 12, 14).…”

Section: Introductionmentioning

confidence: 99%

Safety of outpatient autologous hematopoietic cell transplantation for multiple myeloma and lymphoma

Graff

Singavi

Schmidt

et al. 2015

Bone Marrow Transplant

View full text Add to dashboard Cite

Autologous peripheral stem cell transplantation (AutoHCT) is commonly an inpatient procedure. However, AutoHCT is increasingly being offered on an outpatient basis. To better characterize the safety of outpatient AutoHCT, we compared the outcome of 230 patients who underwent AutoHCT on an inpatient (IP) versus outpatient (OP) basis for myeloma or lymphoma within a single transplant program. All OP transplants occurred in a cancer center day hospital. Hematopoietic recovery occurred earlier in the OP cohort, with median time to neutrophil recovery of 10 vs. 11 days (p<0.001) and median time to platelet recovery of 19 vs. 20 days (p=0.053). 51% of the OP cohort never required admission, with this percentage increasing in later years. Grade 3–4 non-hematologic toxicities occurred in 29% of both cohorts. Non-relapse mortality at one year was 0% in the OP cohort and 1.5% in the IP cohort (p=0.327). Two year progression-free survival was 62% for OP vs. 54% for IP (p=0.155). One and two year overall survival was 97% and 83% for OP vs. 91% and 80% for IP, respectively (p=0.271). We conclude that, with daily outpatient evaluation and aggressive supportive care, outpatient AutoHCT can result in excellent outcomes for myeloma and lymphoma patients.

show abstract

Impact of a change in antibacterial prophylaxis on bacteremia and hospitalization rates following outpatient autologous peripheral blood stem cell transplantation for multiple myeloma

Cited by 14 publications

References 32 publications

Bacteremias following autologous stem cell transplantation for multiple myeloma: Risk factors and outcomes

Bacteremias following autologous stem cell transplantation for multiple myeloma: Risk factors and outcomes

Antimicrobial Resistance in Gram-Negative Rods Causing Bacteremia in Hematopoietic Stem Cell Transplant Recipients: Intercontinental Prospective Study of the Infectious Diseases Working Party of the European Bone Marrow Transplantation Group

Safety of outpatient autologous hematopoietic cell transplantation for multiple myeloma and lymphoma

Contact Info

Product

Resources

About