title: Risk of neutropenic fever and early infectious complications after autologous peripheral blood stem cell transplantation for malignant diseases.
abstract: Autologous peripheral blood stem cell transplantation (auto-PBSCT) has facilitated high-dose chemotherapy for the treatment of various types of malignancy, but the factors affecting the treatment outcome have not been well defined. We evaluated patients who underwent auto-PBSCT (46 patients with hematological malignancies and 39 with solid tumors) to elucidate the risks of background factors, including age, in association with infectious complications. In contrast to former reports, faster engraftment did not influence the incidence of documented infection or neutropenic fever, whereas high age (age > or = 50 years old) and delayed platelet recovery (> or = 18 days) were demonstrated to be positively involved. The odds ratio (OR) for documented infection in elderly patients was 4.94 (95% confidence interval, 1.22-15.8). Another risk factor of infection was the HD-ICE regimen (ifosfamide, carboplatin, etoposide) given to patients with solid tumors (OR, 8.00; 95% confidence interval, 1.61-39.7). In conclusion, we found that elderly patients and patients on the HD-ICE regimen have a higher risk of infectious complications even after auto-PBSCT. Although the clinical indications for auto-PBSCT can be extended to elderly patients, thorough precautions should be taken against infectious complications during the pre-engraftment phase.
authors.affiliation: Second Department of Internal Medicine, Okayama University Medical School, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Fujii
authors.forename: Masako
authors.initials: M
authors.lastname: Aoyama
authors.forename: Katsuji
authors.initials: K
authors.lastname: Shinagawa
authors.forename: Keitaro
authors.initials: K
authors.lastname: Matsuo
authors.forename: Katsuto
authors.initials: K
authors.lastname: Takenaka
authors.forename: Kazuma
authors.initials: K
authors.lastname: Ikeda
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kojima
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Ishimaru
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kiura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ueoka
authors.forename: Kenji
authors.initials: K
authors.lastname: Niiya
authors.forename: Mitsune
authors.initials: M
authors.lastname: Tanimoto
authors.forename: Mine
authors.initials: M
authors.lastname: Harada
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D015994:Incidence; D007239:Infections / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000628:therapy; D009503:Neutropenia / Q000209:etiology*; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous / Q000009:adverse effects