INFECTIOUS COMPLICATIONS OF AUTOLOGOUS BONE-MARROW AND PERIPHERAL STEM-CELL TRANSPLANTATION FOR REFRACTORY LEUKEMIA AND LYMPHOMA

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.