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Early infection in bone marrow transplantation: quantitative study of clinical factors that affect risk.
Engels, E A; Ellis, C A; Supran, S E; Schmid, C H; Barza, M; Schenkein, D P; Koc, Y; Miller, K B; Wong, J B.
Afiliação
  • Engels EA; Department of Medicine, Tupper Institute, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA. engelse@exchange.nih.gov
Clin Infect Dis ; 28(2): 256-66, 1999 Feb.
Article em En | MEDLINE | ID: mdl-10064241
ABSTRACT
Infections remain common life-threatening complications of bone marrow transplantation. To examine clinical factors that affect infection risk, we retrospectively studied patients who received bone marrow transplants (53 autologous and 51 allogeneic). Over a median of 27 hospital days, 44 patients developed documented infections. Both autologous transplantation and hematopoietic growth factor use were associated with less prolonged neutropenia and decreased occurrence of infection (P < or = .05). In a survival regression model, variables independently associated with infection risk were the log10 of the neutrophil count (hazard ratio [HR], 0.49; 95% confidence interval [CI], 0.32-0.75), ciprofloxacin prophylaxis (HR, 0.42; 95% CI, 0.19-0.95), empirical intravenous antibiotic use (HR, 0.09; 95% CI, 0.03-0.32), and an interaction between neutrophil count and intravenous antibiotic use (HR, 1.86; 95% CI, 1.06-3.29). In this model, infection risk increases steeply at low neutrophil counts for patients receiving no antibiotic therapy. Ciprofloxacin prophylaxis and particularly intravenous antibiotic therapy provide substantial protection at low neutrophil counts. These results can be used to model management strategies for transplant recipients.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Transmissíveis / Transplante de Medula Óssea Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male Idioma: En Revista: Clin Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 1999 Tipo de documento: Article País de afiliação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Transmissíveis / Transplante de Medula Óssea Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male Idioma: En Revista: Clin Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 1999 Tipo de documento: Article País de afiliação: Estados Unidos