Febrile complications in the first 100 days after bone marrow transplantation in children: a single center's experience.
One hundred fifty-six episodes of fever occurred in 102 children during the first 100 days after bone marrow transplantation (BMT) performed at a single institution: fever of undetermined origin (FUO), 40.3%; septicemia, 7.1%; pneumonia, 19.2%; other infections, 33.4% of cases. The overall incidence of mortality was 22.6% and of mortality due to infections 17.4%. All FUO episodes resolved. Pneumonia was the major cause of death; 60% of recipients who developed pneumonia died, accounting for 90% of deaths attributable to febrile complications. Interstitial pneumonia, occurred rarely, in 3.9% of all febrile episodes. The Cox model showed that the presence of graft-versus-host disease (GVHD) was related to an approximately ninefold increase in the risk of a first episode of FUO (P value .03). The risk of developing pneumonia was fourfold greater in children who received a transplant from a matched unrelated donor or a mismatched family donor (P value .01). Developments in diagnostic tools are needed to diagnose febrile episodes earlier and more precisely with the aim of reducing early mortality after BMT.
Dell'Orto
M
M
Università di Milano, Ospedale San Gerardo, Monza, Italy.
Rovelli
A
A
Barzaghi
A
A
Valsecchi
M G
MG
Silvestri
D
D
Giltri
G
G
Balduzzi
A
A
Biagi
E
E
Arrigo
C
C
Rossi
M R
MR
Masera
G
G
Uderzo
C
C
D001424:Bacterial Infections / Q000453:epidemiology; D016026:Bone Marrow Transplantation / Q000401:mortality; D002648:Child; D005260:Female; D005334:Fever / Q000453:epidemiology* / Q000209:etiology; D006402:Hematologic Diseases / Q000628:therapy*; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008297:Male; D009181:Mycoses / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology / Q000628:therapy; D015996:Survival Rate; D013997:Time Factors; D014019:Tissue Donors