Characteristics of and risk factors for pneumonia in patients with hematological malignancies developing fever after autologous blood stem cell transplantation.
We analyzed the incidence, etiology, risk factors and outcomes of 49 episodes of pneumonia that developed in 326 adult patients undergoing autologous stem-cell transplantation (ASCT) from January 1990 to December 2005. The median time for the onset of pneumonia after transplantation was 11 days (range 0-148). Empirical antibiotic therapy in patients with pneumonia consisted of piperacillin-tazobactam (20 cases, 49%), third-generation cephalosporin (11 cases, 27%) and carbapenem (8 cases, 19%). Multivariate analysis showed that a higher risk of pneumonia could be predicted for patients with myeloma (P = 0.006) and for patients with an absolute neutrophil count <0.5 x 10(9)/L >7 days (P = 0.008). Cumulative incidence of transplant-related mortality at 6 months was 51% versus 8% for patients with or without pneumonia, respectively (P = 0.001). Pneumonia after ASCT is a severe complication more commonly observed in patients with myeloma and with prolonged duration of neutropenia.
Puig
Noemí
N
Hematology Service, University Hospital La Fe, Valencia, Spain.
De La Rubia
Javier
J
Jarque
Isidro
I
Salavert
Miguel
M
Moscardó
Federico
F
Sanz
Jaime
J
Lorenzo
Ignacio
I
Montesinos
Pau
P
Martín
Guillermo
G
Martínez
Jesús
J
Sanz
Guillermo
G
Blanes
Margarita
M
Sanz
Miguel
M
D000328:Adult; D005260:Female; D005334:Fever / Q000209:etiology*; D005541:Forced Expiratory Volume; D019337:Hematologic Neoplasms / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006410:Hematopoiesis; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D014182:Transplantation, Autologous