Does treatment with haemopoietic growth factors affect the incidence of bacteraemia in adult lymphoma transplant recipients?
Eighty-six consecutive adult patients undergoing ABMT colony-stimulating factor for lymphoma in three (CSF) trials were studied retrospectively to investigate whether the administration of CSFs had a beneficial impact on the incidence of bacteraemia. Forty-nine patients did not receive CSFs and 51% of them developed bacteraemia during the recovery phase. Nineteen patients received M-CSF post-ABMT, 9 G-CSF and 9 GM-CSF; 40%, 33% and 22%, respectively, developed bacteraemia during the recovery phase. Ninety per cent of all infections (Gram +ve and Gram -ve) and 100% of the Gram -ve ones occurred when the absolute neutrophil count (ANC) was < or = 0.1 x 10(9)/l. This period of maximum risk, i.e. the total number of consecutive days with ANC < 0.1 x 10(9)/l, was not shortened by CSFs; however, a decrease in the incidence of bacteraemia was detected in the CSF-treated patients during the above period and this might be a result of enhanced phagocytic function. The incidence of bacteraemia appeared to be related to the type of lymphoma (p < 0.02) regardless of CSF administration: 28 of 59 patients with Hodgkin's disease developed bacteraemia (46.7%) versus 6 of 27 patients (22.2%) with non-Hodgkin's lymphoma.
Tsakona
C P
CP
University College Hospital, Haematology Department, London, UK.
Khwaja
A
A
Goldstone
A H
AH
D000328:Adult; D016470:Bacteremia / Q000453:epidemiology* / Q000209:etiology; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006689:Hodgkin Disease / Q000150:complications / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000628:therapy*; D016173:Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D012189:Retrospective Studies
D016179:Granulocyte Colony-Stimulating Factor; D016173:Macrophage Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor