[Granulocyte recovery and early infection complications in oncologic pediatric patients treated with hematopoietic stem cell transplantation].
OBJECTIVE
Infections during the early post-BMT period are a major cause of morbidity in BMT recipients. We report our experience in a single institution.


METHODS
Clinical reports from all BMT patients between 1989-1995 were reviewed retrospectively. Routine reverse isolation techniques, prophylactic measures and central venous catheter were used in all cases and starting in 1992, G-CSF was also used. Fever in the aplasia period was considered a sign of infection.


RESULTS
Sixty-three BMTs were performed between 1989 and 1995 with 30 being ABMT, 17 allogenic and 16 PBSC. The time for granulocyte recovery was shorter in PBSC + G-CSF patients (d + 11). There were 65 infections in the early post-BMT period: 22 were microbiologically confirmed, 18 of them being of bacterial origin and 14 disseminated. Gram positive bacteria were predominant. There were 6 cases of interstitial pneumonitis, with 3 of them being lethal. Infection-related mortality was 6.3%.


CONCLUSIONS
1) BMTs can be safely performed using conventional reverse isolation. 2) The use of PBSC and G-CSF accelerates granulocyte recovery in BMTs. 3) Infections due to Gram positive bacteria were a major cause of morbidity in our series. 4) Pneumonitis and fungal infections are the most frequent lethal infections in our patients.
Cañete Nieto
A
A
Unidad de Oncología Pediátrica, Hospital Infantil La Fe, Valencia.
Verdeguer Miralles
A
A
Esquembre Menor
C
C
Castel Sánchez
V
V
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006094:Gram-Positive Bacteria; D006098:Granulocytes; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007239:Infections / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors