Infectious complications of autologous bone marrow and peripheral stem cell transplantation for refractory leukemia and lymphoma Journal Article


Authors: Nosanchuk, J. D.; Sepkowitz, K. A.; Pearse, R. N.; White, M. H.; Nimer, S. D.; Armstrong, D.
Article Title: Infectious complications of autologous bone marrow and peripheral stem cell transplantation for refractory leukemia and lymphoma
Abstract: We aimed to characterize the infectious complications of autologous bone marrow (AuBMT) and peripheral stem cell transplantation (PSCT) in patients with refractory leukemia and lymphoma. We performed a retrospective analysis of all patients (n = 56) with refractory leukemia or lymphoma treated with AuBMT or PSCT at Memorial Sloan-Kettering Cancer Center from January 1993 to July 1994. Records were available in 55, of whom 33 (60%) received AuBMT and 22 (40%) PSCT. Fifteen (27%) developed complicated infections, including 13 (39%) treated with AuBMT and two (9%) with PSCT. Complicated infections were caused by bacterial (11 episodes), fungal (four episodes), and viral (four episodes) pathogens. Five (9%) infections were fatal. In a multivariate model, only duration of neutropenia was significantly associated with development of complicated infection (P = 0.006). Thus, 27% of patients with refractory leukemia or lymphoma treated with AuBMT or PSCT developed complicated infections and 9% died of infection. Prolonged neutropenia was significantly associated with development of infection. Patients receiving PSCT had significantly lower rates of complicated infection, presumably due to the associated shorter duration of neutropenia. Future studies are needed to define the role of PSCT as treatment for refractory neoplastic disease.
Keywords: adult; human tissue; middle aged; leukemia; retrospective studies; human cell; major clinical study; neutropenia; cytarabine; infection; etoposide; risk factors; aciclovir; stem cell transplantation; hematopoietic stem cell transplantation; retrospective study; mitoxantrone; lymphoma; medical record; virus infection; gentamicin; bone marrow transplantation; growth factor; bacterial infection; transplantation, autologous; fluconazole; mycosis; oral drug administration; infectious complication; fatality; autologous bone marrow transplantation; norfloxacin; timentin; nystatin; amphotericin b; 4 hydroperoxycyclophosphamide; humans; human; male; female; priority journal; article; autologous transplants
Journal Title: Bone Marrow Transplantation
Volume: 18
Issue: 2
ISSN: 0268-3369
Publisher: Nature Publishing Group  
Date Published: 1996-08-01
Start Page: 355
End Page: 359
Language: English
PUBMED: 8864446
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 22 November 2017 -- Source: Scopus
Citation Impact
MSK Authors
  1. Kent A Sepkowitz
    272 Sepkowitz
  2. Mary H White
    43 White
  3. Stephen D Nimer
    347 Nimer
  4. Donald Armstrong
    240 Armstrong
  5. Roger Niles Pearse
    14 Pearse