Infectious complications after high-dose chemotherapy and autologous stem cell transplantation: comparison between patients with lymphoma or multiple myeloma and patients with solid tumors

Abstract

patients (66 with solid tumor, 36 with lymphoma, 14 with multiple myeloma, one with acute leukemia) underwent 178 cycles of high-dose chemotherapy and autologous stem cell transplantation (ASCT) at our institution. We retrospectively analyzed the infectious complications that occurred after ASCT. Median duration of neutropenia (granulocyte count Ͻ0.5 × 10 9 /l ) was 8 days, the overall incidence of fever requiring antimicrobial treatment was 63%. 35.4% of patients had fever of unknown orign (FUO), whereas primary bacteremia occurred in 21.3%, pneumonia in 3.4% and severe skin infection in 1.1% of patients. Invasive fungal infections occurred in three, and enterocolitis in one patient. Infection was fatal in three patients (2.6%), in each case due to septic shock. The most frequently isolated pathogens were Grampositive cocci. Median time to defervescence with antimicrobial therapy was 4 days (6 days in patients with bacteremia or other severe infection, and 3 days in patients with FUO). First-line antimicrobial therapy was successful in 65% of patients with FUO and 30.6% of patients with documented infections. With respect to the incidence, type and clinical course of infection, no significant differences between patients with lymphoma or multiple myeloma and those with solid tumors were detected. Bone Marrow Transplantation (2001) 27, 525-529.

Transplantation without growth factor: engraftment kinetics after stem cell transplantation for primary systemic amyloidosis (AL)

“…17 In a study of infectious complications in patients with multiple myeloma who were receiving high-dose therapy, primary bacteremia was seen in 21.3%. 18 Fatal infections occurred in 2.6%. A second study reported that infections were documented in 30% of patients with myeloma after peripheral blood progenitor cell transplantation.…”

MBL2 polymorphism and risk of severe infections in multiple myeloma patients receiving high-dose melphalan and autologous stem cell transplantation

“…7,8 Infections are very common during this treatment: up to 80% of patients have fever, and more than one third suffer from well-defined infections. [9][10][11] These numbers are based on quite small series of patients. A closer description of infectious toxicity is not seen in the large prospective trials of ASCT.…”

Autologous tandem transplantation: almost complete reduction of neutropenic fever following the second transplantation by ex vivo expanded autologous myeloid postprogenitor cells

“…1,2 The rate of infectious complications increases with the duration of neutropenia. 3 There are several possibilities to shorten the pancytopenic period after autologous transplantation.…”