Jd. Nosanchuk et al., INFECTIOUS COMPLICATIONS OF AUTOLOGOUS BONE-MARROW AND PERIPHERAL STEM-CELL TRANSPLANTATION FOR REFRACTORY LEUKEMIA AND LYMPHOMA, Bone marrow transplantation, 18(2), 1996, pp. 355-359
We aimed to characterize the infectious complications of autologous bo
ne marrow (AuBMT) and peripheral stem cell transplantation (PSCT) in p
atients with refractory leukemia and lymphoma, We performed a retrospe
ctive analysis of all patients (n = 56) with refractory leukemia or ly
mphoma treated with AuBMT or PSCT at Memorial Sloan-Fettering Cancer C
enter from January 1993 to July 1994. Records were available in 55, of
whom 33 (60%) received AuBMT and 22 (40%) PSCT, Fifteen (27%) develop
ed complicated infections, including 13 (39%) treated with AuBMT and t
wo (9%) with PSCT. Complicated infections were caused by bacterial (11
episodes), fungal (four episodes), and viral (four episodes) pathogen
s, Five (9%) infections were fatal, In a multivariate model, only dura
tion of neutropenia was significantly associated with development of c
omplicated infection (P = 0.006), Thus, 27% of patients with refractor
y leukemia or lymphoma treated with AuBMT or PSCT developed complicate
d infections and 9% died of infection, Prolonged neutropenia was signi
ficantly associated with development of infection, Patients receiving
PSCT had significantly lower rates of complicated infection, presumabl
y due to the associated shorter duration of neutropenia, Future studie
s are needed to define the role of PSCT as treatment for refractory ne
oplastic disease.