Early infections in patients undergoing high-dose treatment with stem cell support: a comparison of patients with non-Hodgkin lymphoma and multiple myeloma.
BACKGROUND
Infections are life-threatening complications in patients undergoing high-dose chemotherapy with stem cell support (HDT). Knowledge of the infectious pathogens is essential to make a safe outpatient setting.


METHODS
We conducted a retrospective study of 208 patients treated with HDT. The population included non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) patients. No patients received prophylactic antibacterial treatment.


RESULTS
Pathogens were isolated from 44% of all patients. MM patients more frequently had multiple pathogens in blood cultures (38% versus 25%). Transplantation related mortality was similar between the groups.


CONCLUSIONS
The frequency of isolated pathogens, positive blood cultures, and the diversity of pathogens were higher in MM patients as compared to NHL patients. However, this did not translate into higher transplantation-related mortality, probably because broad-spectrum antibiotic treatment could be initiated immediately. A safe outpatient setting with prophylactic antibiotic treatment is dependent on continuous collection and registration of microbiological findings.
Gang
A O
AO
Center for Cancer Immune Therapy, Department of Haematology, Herlev University Hospital, Copenhagen, Denmark. aog@dadlnet.dk
Arpi
M
M
Gang
Uffe J O
UJ
Vangsted
A J
AJ
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000890:Anti-Infective Agents / Q000494:pharmacology / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005658:Fungi / Q000187:drug effects / Q000302:isolation & purification; D016829:Giardia lamblia / Q000187:drug effects / Q000302:isolation & purification; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism / Q000628:therapy; D009894:Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology* / Q000469:parasitology; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality; D055815:Young Adult
D000890:Anti-Infective Agents; D000970:Antineoplastic Agents