title: Low infectious morbidity in patients with heavily pretreated hematological malignancies receiving autologous peripheral blood stem cell transplantation without antimicrobial prophylaxis.
abstract: The use of prophylactic antimicrobials during autologous peripheral blood stem cell transplantation (APBSCT) remains controversial. A prospective study was therefore conducted to examine whether the use of prophylactic antimicrobials is necessary. In this study, all the antimicrobials were given therapeutically rather than prophylactically. Twenty-three consecutive patients with heavily pretreated hematological malignancies were enrolled. All of the 23 patients had at least one episode of fever during APBSCT and most were fever of unknown origin (78.3%). Clinically or microbiologically documented infections occurred in only five patients (21.7%). These included bacteremias (three patients), perianal abscess (one patient), and catheter-related phlebitis (one patient). No death, invasive fungal infection, or serious adverse events occurred. The medium duration of fever, intravenous antimicrobial therapy, and hospital stay after transplantation were 5, 10, and 17 days, respectively. In conclusion, without using prophylactic antimicrobials, the infectious morbidity during APBSCT is low even in patients with heavily pretreated hematological malignancies.
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, China Medical College Hospital, 2 Yuh Der Road, Taichung 404, Taiwan. superyeh@pavo.seed.net.tw
authors.forename: Su-Peng
authors.initials: SP
authors.lastname: Yeh
authors.forename: C-F
authors.initials: CF
authors.lastname: Chiu
authors.forename: W-J
authors.initials: WJ
authors.lastname: Lo
authors.forename: C-L
authors.initials: CL
authors.lastname: Lin
authors.forename: C-T
authors.initials: CT
authors.lastname: Hsueh
authors.forename: Y-M
authors.initials: YM
authors.lastname: Liao
authors.forename: Y-C
authors.initials: YC
authors.lastname: Shen
mesh_terms: D000328:Adult; D019072:Antibiotic Prophylaxis; D003131:Combined Modality Therapy; D005334:Fever / Q000209:etiology; D019337:Hematologic Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D007239:Infections / Q000188:drug therapy* / Q000209:etiology; D007902:Length of Stay; D008875:Middle Aged; D009017:Morbidity; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D011446:Prospective Studies; D014182:Transplantation, Autologous / Q000009:adverse effects