Febrile neutropenia in allogeneic and autologous peripheral blood stem cell transplantation and conventional chemotherapy for malignancies
Febrile neutropenia in allogeneic and autologous peripheral blood stem cell transplantation and conventional chemotherapy for malignancies
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DOI：
10.1038/sj.bmt.1702503
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发表时间：
2000-07-01
影响因子：
4.8
通讯作者：
Arat, M
中科院分区：
文献类型：
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作者：
Çelebi, H;Akan, H;Arat, M
中性粒细胞减少症患者感染的风险和结果主要取决于中性粒细胞减少症的持续时间、潜在疾病或治疗。本研究旨在比较常规化疗(CCT)、异基因外周血造血干细胞移植(AllPBSCT)和自体PBSC移植(AutoPBSCT)后的感染和预后，在中性粒细胞减少期，在单个中心，共145例患者(CCT组50例，异体PBSCT组50例，AutoPBSCT组45例)，在异基因外周血化疗组中，86%的患者(43/50)，在自体PBSCT组中，93%的患者(42/45)和CCT组中92%(46/50)的患者在中性粒细胞减少期至少发生过一次发热事件(P>；病原学和(或)临床证实感染率分别为50%(25/50)、42%(19/45)和48%(24/50)。CRAM阳性病原菌，主要是凝固酶阴性葡萄球菌是所有组中最常见的细菌血症原因。异基因外周血干细胞移植组和自体外周干细胞移植组的中枢神经系统感染发生率显著高于常规移植组(P<；0.008和P<；0.04)。外周血干细胞移植组导管感染较多(P<；0.006)，外周血干细胞移植组肺部感染发生率较高(P<；005)，外周血干细胞移植组较异基因外周血干细胞移植组需要更长时间的抗生素使用(P<；005)，中性粒细胞减少症的持续时间和治疗类型，不影响发热事件的发生率，但影响感染类型。
The risk and outcome of infection in febrile neutropenic patients is mainly determined by the duration of neutropenia, the underlying disease or the treatment. This study was undertaken to compare infections and the outcome after conventional chemotherapy (CCT), allogeneic PBSC transplantation (alloPBSCT) or autologous PBSC transplantation (autoPBSCT), during the period of neutropenia, in a single center, A total of 145 patients (50 in CCT group, 50 in alloPBSCT and 45 in autoPBSCT) were evaluated, In the alloPBSCT group, 86% of the patients (43/50), in the autoPBSCT group 93% of the patients (42/45) and in the CCT group 92% (46/50) of the patients had at least one febrile episode during their neutropenic period (P > 0.05), Microbiologically and/or clinically documented infection rates were 50% (25/50), 42% (19/45) and 48% (24/50) respectively. Cram-positive pathogens, mostly coagulase-negative staphylococci were the most frequent cause of bacteremias in all groups. The frequency of CNS infections was significantly higher in the alloPBSCT and autoPBSCT groups compared to the CCT group (P < 0.008 and P < 0.04, respectively). Catheter infections were frequent ill the PBSCT groups and pulmonary infections were more frequent in the CCT group (P < 0.05), The CCT group needed longer antibiotic usage compared to the alloPBSCT group (P < 0.006), The duration of neutropenia and the type of treatment given, does not affect the rate of febrile episodes, but affects the type of infections in febrile neutropenic patients.