Development of early neutropenic fever, with or without bacterial infection, is still a significant complication after reduced-intensity stem cell transplantation

Akiko Hori, Masahiro Kami, Sung Won Kim, Aki Chizuka, Rie Kojima, Osamu Imataki, Michiyo Sakiyama, Tamae Hamaki, Yasushi Onishi, Noriko Usubuchi, Yukiko Kishi, Naoko Murashige, Kinuko Tajima, Shigesaburo Miyakoshi, Yuji Heike, Shigeru Masuo, Shuichi Taniguchi, Yoichi Takaue

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21 Citations (Scopus)

Abstract

Little information is available on the clinical characteristics of infectious complications that occur in the early period after reduced-intensity stem cell transplantation (RIST). We retrospectively investigated the clinical features of neutropenic fever and infectious episodes within 30 days after RIST in 76 patients who had received fluoroquinolones as part of their antibacterial prophylaxis. Preparative regimens included cladribine 0.66 mg/kg or fludarabine 180 mg/m2 plus busulfan 8 mg/kg. All but 1 patient survived 30 days after transplantation, and 75 patients (99%) became neutropenic within a median duration of 9 days. Neutropenic fever was observed in 29 patients (38%), and bacterial infection was confirmed in 15 (20%) of these, including bacteremia (n = 13), bacteremia plus pneumonia (n = 1), and urinary tract infection (n = 1). The causative organisms were gram-positive (n = 9) and gram-negative organisms (n = 7), with a mortality rate of 6%. Neither viral nor fungal infection was documented. Multivariate analysis showed that the presence of neutropenia at the initiation of preparative regimens was an independent risk factor for subsequent documented bacterial infections (P = .026; 95% confidence interval, 1.25-35.1). We conclude that neutropenic fever and bacteremia remain common complications in RIST.

Original languageEnglish
Pages (from-to)65-72
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume10
Issue number1
DOIs
Publication statusPublished - 2004 Jan 1
Externally publishedYes

Keywords

  • Bacterial infection
  • Neutropenic fever
  • Reduced-intensity stem cell transplantation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Hori, A., Kami, M., Kim, S. W., Chizuka, A., Kojima, R., Imataki, O., Sakiyama, M., Hamaki, T., Onishi, Y., Usubuchi, N., Kishi, Y., Murashige, N., Tajima, K., Miyakoshi, S., Heike, Y., Masuo, S., Taniguchi, S., & Takaue, Y. (2004). Development of early neutropenic fever, with or without bacterial infection, is still a significant complication after reduced-intensity stem cell transplantation. Biology of Blood and Marrow Transplantation, 10(1), 65-72. https://doi.org/10.1016/j.bbmt.2003.09.006