Background.-Studies on the infectious complications postengrafment in pediatr ic stem cell transplantation patients are rare. The aim of this study was to ass ess the incidence, types, outcome and factors affecting la...Background.-Studies on the infectious complications postengrafment in pediatr ic stem cell transplantation patients are rare. The aim of this study was to ass ess the incidence, types, outcome and factors affecting late infections. Patient s and methods. -A single-institution retrospective analysis was done of infect ions recorded in the first year following engrafment in children who underwent a utologous stem cell transplantation for solid tumors from January 1991 to Decemb er 2000. A systematic antimicrobial chemoprophylaxis of TMP/SMX was administered . Patients who were at high risk for varicellazona virus infection received prop hylactic acyclovir. Results. -Eighty-four assessable patients were enrolled. F ifty-four patients (64%) underwent autologous peripheral blood stem cell trans plantation and 30 patients (36%) underwent bone marrow transplantation. Forty- nine episodes of infections were documented in 39 patients(46%) of whom 27 pati ents (32%) developed infections after the first 100 days post transplantation. Bacterial septicemia occurred in nine patients of whom four patients had a cathe ter-related septicemia. Twelve patients (14%) developed localized herpes zoste r infection. Local fungal infection occurred in five patients. Infection-relate d death occurred in one patient with non-documented pneumonitis. Univariable an alysis showed a correlation between the CD34+cell dose < 7.5×106/kg and the de velopment of infections (P =0.04). Patients who did not go into remission after transplantation where at high risk for septicemia (P =0.007)-. Multivariate ana lysis showed that a history of varicella or pretransplant varicella-zona positi vity was the only significant factor for development zoster infection (P =0.01). Conclusion. -Our study shows that infections in the first year postengrafment following autologous stem cell transplantation for solid tumors have a good prog nosis and that the use of TMP/SMX should be the single systematic antimicrobial prophylaxis. The CD34+cell dose seems to play a role in preventing late infecti ons.展开更多
文摘Background.-Studies on the infectious complications postengrafment in pediatr ic stem cell transplantation patients are rare. The aim of this study was to ass ess the incidence, types, outcome and factors affecting late infections. Patient s and methods. -A single-institution retrospective analysis was done of infect ions recorded in the first year following engrafment in children who underwent a utologous stem cell transplantation for solid tumors from January 1991 to Decemb er 2000. A systematic antimicrobial chemoprophylaxis of TMP/SMX was administered . Patients who were at high risk for varicellazona virus infection received prop hylactic acyclovir. Results. -Eighty-four assessable patients were enrolled. F ifty-four patients (64%) underwent autologous peripheral blood stem cell trans plantation and 30 patients (36%) underwent bone marrow transplantation. Forty- nine episodes of infections were documented in 39 patients(46%) of whom 27 pati ents (32%) developed infections after the first 100 days post transplantation. Bacterial septicemia occurred in nine patients of whom four patients had a cathe ter-related septicemia. Twelve patients (14%) developed localized herpes zoste r infection. Local fungal infection occurred in five patients. Infection-relate d death occurred in one patient with non-documented pneumonitis. Univariable an alysis showed a correlation between the CD34+cell dose < 7.5×106/kg and the de velopment of infections (P =0.04). Patients who did not go into remission after transplantation where at high risk for septicemia (P =0.007)-. Multivariate ana lysis showed that a history of varicella or pretransplant varicella-zona positi vity was the only significant factor for development zoster infection (P =0.01). Conclusion. -Our study shows that infections in the first year postengrafment following autologous stem cell transplantation for solid tumors have a good prog nosis and that the use of TMP/SMX should be the single systematic antimicrobial prophylaxis. The CD34+cell dose seems to play a role in preventing late infecti ons.
