title: Infectious complications during neutropenia subsequent to peripheral blood stem cell transplantation.
abstract: Type, severity and incidence of infection during the neutropenic period after peripheral blood stem cell transplantation (PBSCT) for treatment of malignant disease were studied in 66 patients treated at a single institution. Data of 34 female and 32 male patients with a median age of 43 years suffering from leukemia (12), lymphoma (35), multiple myeloma (six) or solid tumors (13) were retrospectively analyzed. All patients had received at least 2.5 x 10(6) CD34-positive cells for stem cell rescue after high-dose chemotherapy. Ninety-four percent of the patients experienced at least one febrile episode during their post-transplant course. The patients recovered quickly and defervesced after a median of 4 days. The incidence of bacteremia was 39% and gram-positive cocci were the predominant pathogens. In contrast, severe organ infections were rare. Only 5% of the patients suffered from lung infiltrates. No invasive fungal infections were observed. No transplant-related deaths occurred in the 66 patients studied. We conclude that the severe, but shortlasting neutropenia after peripheral blood stem cell transplantation is associated with a high incidence of bacterial infection. The severity of the majority of these infections is moderate. With appropriate anti-infective therapies these infections can be managed and life-threatening infectious complications, in particular fungal infections, are rare. Empirical anti-infective regimens specifically designed for this clinical situation should be explored.
authors.affiliation: IIIrd Department of Medicine, Johannes Gutenberg University Hospital, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Kolbe
authors.forename: D
authors.initials: D
authors.lastname: Domkin
authors.forename: H G
authors.initials: HG
authors.lastname: Derigs
authors.forename: S
authors.initials: S
authors.lastname: Bhakdi
authors.forename: C
authors.initials: C
authors.lastname: Huber
authors.forename: W E
authors.initials: WE
authors.lastname: Aulitzky
mesh_terms: D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D003141:Communicable Diseases / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D009503:Neutropenia / Q000150:complications*; D012189:Retrospective Studies
chemical_list: D000890:Anti-Infective Agents