Patients with malignant lymphomas experience a higher rate of documented infections than patients with breast cancer after high-dose chemotherapy with autologous peripheral stem cell transplantation

The influence of underlying disease on documented infections has rarely bee n addressed in patients treated with high-dose chemotherapy (HDCT) and subs equent autologous peripheral blood stem cell transplantation (PBSCT). Becau se autografting has been used most frequently for malignant lymphomas and b reast cancer, we analyzed in a retrospective study the data of 100 consecut ive adult patients with either malignant lymphomas (group A, n = 50) or bre ast cancer (group B, n = 50) treated with HDCT at a single institution. The number of autografted CD34 + cells was not statistically different in eith er group. In this paper, we show for the first time that there is a signifi cant difference in clinically or microbiologically documented infections in these groups of patients: documented infections occurred in 30% of maligna nt lymphoma patients but only in 4% of breast cancer patients (P=0.001). Of all isolated microorganisms, 78% were gram-positive. Because most of the d ocumented infections were due to staphylococci, further studies should pros pectively evaluate preventive measures to reduce the high incidence of thes e infections. This is especially important for lymphoma patients, who can b e regarded as a high-risk group concerning gram-positive bacteremia.