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Complications Post Transplant

Infections during mobilizing chemotherapy and following autologous stem cell transplantation

Bone Marrow Transplantation volume 28, pages 1129–1134 (2001)Cite this article

Abstract

Autologous peripheral blood stem cells (PBSC), for transplantation following high-dose chemotherapy, are collected using regimens containing cytokines with or without chemotherapy. The added period of neutropenia prior to stem cell transplantation (SCT) in patients receiving chemotherapy mobilization may increase the risk of infections following transplantation. We studied the incidence of culture-positive infections in 107 consecutive patients who were divided into three groups, according to whether they experienced extended neutropenia during chemotherapy for stem cell mobilization as well as post autotransplant. All the patients received antibiotic prophylaxis and hematopoietic growth factors during neutropenia. The total duration of pre-transplant neutropenia differed among the three mobilization schemes (growth factors alone; one cycle; or two cycles of chemotherapy plus growth factor for mobilization) at 0, 6 and 18 days, respectively (median). However the post-autograft time to myeloid engraftment was similar at 10 days (median). The incidence of culture-proven infections in all three groups was similar. Using fluconazole for yeast prophylaxis, 40% patients developed gastrointestinal colonization with yeast, and the majority of speciated isolates were Candida glabrata. Bacteremia developed in 22% and 9% of patients with S. epidermidis and Gram-negative organisms, respectively, while 11% developed C. difficile-associated diarrhea. In conclusion, treatment using none, one or two cycles of mobilizing chemotherapy pre-transplant does not influence the overall incidence of infections among autologous SCT recipients. However, although post-transplant neutropenia is brief, infections remain a significant cause of morbidity.

Bone Marrow Transplantation (2001) 28, 1129–1134.

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  1. AA Toor

    Present address: Cardinal Bernardin Cancer Center, Loyola University Medical Center, 2160 South First Ave, Maywood, 60153, IL, USA

Authors and Affiliations

  1. Blood and Marrow Transplant Program and the Department of Medicine, University of Minnesota, Minneapolis, MN, USA

    AA Toor, J-A van Burik & DJ Weisdorf

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  1. AA Toor
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Toor, A., van Burik, JA. & Weisdorf, D. Infections during mobilizing chemotherapy and following autologous stem cell transplantation. Bone Marrow Transplant 28, 1129–1134 (2001). https://doi.org/10.1038/sj.bmt.1703307

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