Evaluation of infections developing during autologous hematopoietic stem cell transplantation in AML patients

Year 2021, Volume: 35 Issue: 3, 377 - 384, 30.12.2021

Selda Kahraman

Abstract

Infections are the leading treatment-related cause of mortality and morbidity associated with high dose therapy with autologous hematopoietic stem cell support (HSCT). The aim of the study is to evaluate the data of 47 patients with AML who developed infections in association with autologous HSCT in Izmir Medicalpark Hospital between November 2012 and April 2018.
Materials and Methods: This study is a retrospective evaluation of the data from 47 patients with AML who developed infections in association with autologous HSCT. All infection episodes were noted, beginning from the neutropenia period until the development of neutrophil engraftment.
Results: 24 patients were female and 23 patients were male. The median age at the occurrence of the condition was 39 years (range:18-68). Neutrophil engraftment occurred at an average of 11 days after the transplantation, platelet engraftment occurred at an average of 21 days. In 41 (87.2%) patients neutropenic fever occurred during transplantation. The cause of fever remained unknown in 20% of the patients, 70% of the patients had a microbiologically documented infection and 10% of the patients had only clinically documented infection. 19 patients had a catheter related infections, 7 patients had pneumonia, 8 patients had urinary tract infection and 3 patients had possible invasive pulmonary aspergillosis.
Conclusion: In our department, infections do not present a significant risk for mortality in autologous HSCT among patients with AML. Early detection of the causative agent of the infection is of crucial importance for an optimal treatment and prognosis.
Keywords: AML, autologous stem cell transplantation, infection

Keywords

AML, autologous stem cell transplantation, infection

References

• 1-Weaver CH, Schwartzberg LS, Hainsworth J, Greco FA, Li W, Buckner CD, West WH: Treatment-related mortality in 1000 consecutive patients receiving high-dose chemotherapy and peripheral blood progenitor cell transplantation in community cancer centers. Bone Marrow Transplant 1997; 19: 671–678. 384 Infections developing in autologous transplantation in
• 2. Auner HW, Sill H, Mulabecirovic A, Linkesch W, Krause R: infectious complications after autologous hematopoietic stem cell transplantation: comparison of patients with acute myeloid leukemia, malignant lymphoma, and multiple myeloma. Ann Hematol 2002; 81: 374–377.
• 3. Reich G, Mapara MY, Reichardt P, Dorken B, Maschmeyer G: Infectious complications after high-dose chemotherapy and autologous stem cell transplantation: comparison between patients with lymphoma or multiple myeloma and patients with solid tumors. Bone Marrow Transplant 2001; 27:525–529.
• 4. Hughes WT, Armstrong D, Bodey GP, Brown AE, Edwards JE, Feld R et all: 1997 guidelines for he use of antimicrobial agents in neutropenic patients with unexplained fever. Infectious Diseases Society of America. Clin Infect Dis 1997; 25: 551–573.
• 5. Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA, et al. Clinical practice guideline for the Use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America IDSA guidelines. Clin Infect Dis 2011; 52:56-93.
• 6. Averbuch D, Orasch C, Cordonnier C, Livermore DM, Mikulska M, Viscoli C, et al. European guidelines for empirical antibacterial therapy for febrile neutropenic patients in the era of growing resistance: summary of the 2011 4th European Conference on Infections in Leukemia. Haematologica 2013; 98:1826-35.
• 7. Bodey GP, Buckley M, Sathe YS, Freireich EJ. Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann Intern Med 1966; 64: 328–340
• 8. Auner HW, Zebisch A, Ofner P, Sill H, Linkesch W, Krause