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Autológossejt-transzplantációt követo korai infekciók epidemiológiája. Egy hazai centrumban kezelt 699 beteg adatainak elemzése. / [Epidemiology of early infections after autologous hematopoietic stem cell transplantation. Analysis of data from 699 patients treated in a Hungarian centre].
Orv Hetil ; 161(3): 103-109, 2020 Jan.
Artículo en Húngaro | MEDLINE | ID: mdl-31928060


Autologous hemopoietic stem cell transplantation remains a promising therapy in certain malignant and non-malignant conditions. The procedure, however, will increase the risk of complications, most notably early and late infections.


To analyze the frequency and spectrum of pathogens in early (<+100 days) post-transplant infections and to evaluate risk factors for mortality.


Prospectively collected data from 699 patients undergoing autologous hemopoietic stem cell transplantation between 2007 and 2014 at our center were retrospectively reviewed and analyzed.


The median age of 699 patients was 56 (interquartile range: 43-62) years, 54% (376) were male. 25 patients have been transferred to other centers and 19 patients were lost to follow up. Neutropenic fever occurred in 69.8% (488) of patients. In addition, 102 infectious episodes in 96 patients were identified. Most commonly bacteremia occurred (49 episodes) with a median onset of 7 (5-11) days. The majority (33/49) of bacteremias have been observed during the pre-engraftment period. Their incidence proved to be higher in patients with malignant lymphoma compared to individuals with plasma cell disorders (p = 0.0005, OR: 2.41, 95% CI: 1.49-3.99). 12 episodes of viral infections and 8 cases of proven or probable invasive mycoses have been identified. Among the 655 patients with complete follow up, 16 in-hospital deaths (2.4%) occurred, 8 of them were associated with infections. Survival was adversely affected by early infections (p = 0.0001).


In autologous stem cell transplantation, microbiologically unconfirmed neutropenic fever is common. Documented early bacteremia, however, is infrequent. Lymphoma patients have a significantly higher chance to develop bloodstream infections compared to individuals with plasma cell disorders. Early infections decrease the chance of survival; thus, an effective prophylaxis and therapy remains of paramount importance. Orv Hetil. 2020; 161(3): 103-109.





Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Infecciones Bacterianas / Trasplante Autólogo / Trasplante de Células Madre Hematopoyéticas / Fiebre / Neutropenia Aspecto clínico: Etiología / Pronóstico Límite: Adulto / Humanos / Masculino / Media edad País/Región como asunto: Europa Idioma: Húngaro Revista: Orv Hetil Año: 2020 Tipo del documento: Artículo