[Clinical analysis of 29 children with early infectious complications following hematopoietic stem cells transplantation].
OBJECTIVE
To study the clinical features and the incidence of early infectious complications following children hematopoietic stem cells transplantation (HSCT).


METHODS
The clinical data of 29 cases with early infectious complications following HSCT was retrospectively analyzed.


RESULTS
The incidence of early infectious complications following HSCT in 31 children (including 22 cord blood transplantation and 9 peripheral blood stem cells transplantation) was 94% (29/31). The first occurrence of the early infectious complications was at a median of 6 (0 - 22) days, the peak time of incidence was at a median of 4 - 7 days post transplantation. The duration of the first early infectious complications was at a median of 9 (3 - 20) days. The occurrence of the second early infectious complications was at a median of 19 (13 - 27) days. For all of the 29 children, when they developed early infectious complications their absolute neutrophil counts (ANC) were all > 0.5 x 10(9)/L. The most common infectious sites were the digestive tract (oral and gastro-intestinal mucositis) and then the respiratory tract. Gram negative blood infections were quite frequent and Pseudomonas aeruginosa was common in the oral-pharynx discharge cultures. Two children had Mycoplasma pneumonia infections and there were 4 incidences with fever but no definite infectious foci. The incidence and duration of early infectious complications following hematopoietic stem cells transplantation were associated with the duration of neutropenia. The source and the MNCs dose of the graft, the difference of conditioning regimen and GVHD prophylaxis method did not have a significant impact on the incidence and duration of early infectious complications. Antibiotic prophylaxis (including Tienam) could delay the occurrence of the early infections significantly.


CONCLUSIONS
The incidence and duration of early infectious complications following hematopoietic stem cells transplantation were directly associated with the duration of neutropenia. Tienam regimen could postpone the early infections incidence and had effect of preventing the early infectious complications.
Li
Yang
Y
Department of Pediatrics, The Second Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510120, China.
Huang
Shao-liang
SL
Fang
Jian-pei
JP
Zhou
Dun-hua
DH
Chen
Chun
C
D000293:Adolescent; D019072:Antibiotic Prophylaxis; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D015377:Cilastatin / Q000627:therapeutic use; D000077728:Cilastatin, Imipenem Drug Combination; D004338:Drug Combinations; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D015994:Incidence; D007239:Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D007938:Leukemia / Q000628:therapy*; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors
D004338:Drug Combinations; D015377:Cilastatin; D015378:Imipenem; D000077728:Cilastatin, Imipenem Drug Combination