engleski

Infectious Complications Following Autologous Stem Cell Transplantation in Patients with Lymphoma

Purpose: Infections remain a major cause of morbidity and mortality following autologous hematopoietic stem cell transplantation. Knowledge of local epidemiology and patients’ risk factors are essential for their optimal management. Methods: 72 consecutive patients (median age 45, range 19-68 yrs) with relapsed or refractory Non-Hodgkin’ s Lymphoma (NHL, n=53) and Hodgkin’ s Disease (HD, n=19) treated with autologous peripheral blood stem cell transplantation (PBSCT) in a single center have been evaluated for infectious complications following PBSCT. Results: Febrile neutropenia (FN) occurred in 45 (62.5%) patients at a mean of 6 days after transplantation (range 1-9, SD 1.8). Twelve patients (26.7%) had proven bacteremias, 11 (24.4%) other microbiologically documented infections (MDIs) and 22 (48.9%) had clinically documented infections (CDIs). Gram+ microorganisms were responsible for the majority of all documented infections (58.3% of bacteremias and 54.5% of other MDIs). One patient died as a consequence of sepsis. Correlations of a number of variables available at time of FN onset with the duration of febrile episode have been investigated. Patients with higher CRP levels at FN onset and those with earlier onset of fever following PBSCT had significantly longer (p=0.03 and p=0.002, respectively) duration of fever. Other variables, including age, No. of previous lines of therapy, No. of stem cells reinfused, ANC and monocyte counts as well as peak temperature values at day of fever onset did not show statistically significant correlations with duration of fever. All patients with diabetes developed FN and, although not reaching statistical significance (p=0.08), its duration was longer in comparison to other patients. Conclusions: Infections are serious but manageable complications of PBSCT.

Infections; Stem cell transplantation; Lymphoma

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