[Infectious complications after transplantation of autologous hemopoietic blood cells in patients with hematological malignancies].
OBJECTIVE
To characterize infectious complications arising within 30 days after transplantation of autologous hemopoietic blood cells in 42 patients with hematological malignancy (HM); to compare the course of early posttransplantation period with reference to a kind of high-dose conditioning and dose of transplanted CD34+ cells.


METHODS
Autotransplantation (AT) was conducted as consolidation of a complete or partial remission in 20 patients with multiple myeloma, 14 patients with lymphogranulomatosis and lymphosarcoma, 7 patients with acute leukemia and 1 patient with rabdomyosarcoma. The program of pretransplantation conditioning corresponded to the disease form and included: melphalan, BEAM, busulphane-cyclophosphamide. The number of transplanted CD34+ cells was 1.7-20.1 (median 5.3) x l0(6) cell/kg. The transplantation was followed by selective intestinal decontamination and mycosis prophylaxis. Fever was managed with antibiotics.


RESULTS
An early period after AT ran without febrile episodes in 7 (17%) patients. This allowed physicians to avoid systemic antibiotic therapy. The infectious focus was not definitely localized in 35 patients with febrile fever in 77% cases. Clinically and bacteriologically verified infections were detected in 8 (19%) patients: 7 cases of pneumonia and 1 of bacteriemia. None of the patients died of infection early after AT. Not a single case of invasive aspergillesis was registered.


CONCLUSIONS
Incidence and features of infections did not vary with the above diseases and did not depend on the dose of transplanted CD34+ cells. The kind of high-dose conditioning had a significant influence on the time of granulocyte recovery, duration of agranulocytosis, duration of one febrile episode and of antibiotic therapy. The dose of transplanted CD34+ cells also influenced the time of granulocyte recovery and duration of antibiotic therapy.
Mendeleeva
L P
LP
Mitish
N E
NE
Kliasova
G A
GA
Petrova
N A
NA
Liubimova
L S
LS
Gribanova
E O
EO
Pokrovskaia
O S
OS
Garanzha
T A
TA
Kostina
I E
IE
Kalinin
N N
NN
Gretsov
E M
EM
Savchenko
V G
VG
D000328:Adult; D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D045363:Pneumocystis carinii / Q000302:isolation & purification; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D013210:Staphylococcus / Q000302:isolation & purification; D013997:Time Factors; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous
D000900:Anti-Bacterial Agents