title: Characteristics of and risk factors for pneumonia in patients with hematological malignancies developing fever after autologous blood stem cell transplantation.
abstract: 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.
authors: Hematology Service, University Hospital La Fe, Valencia, Spain.
authors: Noemí
authors: N
authors: Puig
authors: Javier
authors: J
authors: De La Rubia
authors: Isidro
authors: I
authors: Jarque
authors: Miguel
authors: M
authors: Salavert
authors: Federico
authors: F
authors: Moscardó
authors: Jaime
authors: J
authors: Sanz
authors: Ignacio
authors: I
authors: Lorenzo
authors: Pau
authors: P
authors: Montesinos
authors: Guillermo
authors: G
authors: Martín
authors: Jesús
authors: J
authors: Martínez
authors: Guillermo
authors: G
authors: Sanz
authors: Margarita
authors: M
authors: Blanes
authors: Miguel
authors: M
authors: Sanz
mesh_terms: 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