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2012, Number 4

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Rev cubana med 2012; 51 (4)

Infectious complications in the immediate early post-transplantation of hematopoietic stem cells

Moya PI, Muñío PJE, Carnot UJ, Rodríguez FY, Chávez MR, Rodríguez RCR

Language: Spanish
References: 30
Page: 291-301
PDF size: 57.46 Kb.


ABSTRACT

A retrospective and descriptive study was carried out in the hematological service of "Hermanos Ameijeiras" clinical and surgical hospital from January 1985 to December 2008, in order to determine the infectious complications found in patients with hematopoietic stem cell transplants in the early post-transplantation period (0 to 30 days). Out of 179 transplants, 127 were autologous, 45 allogenic and 7 "mini-transplants". The main indications for transplantation were non-Hodgking's lymphomas in 54 patients (30.2 %), acute non-lymphoblastic leukemia in 53 (29.6 %) and Hodgkin's lymphomas in 26 patients (14.5 %). The mostly used conditioning schedule was cyclophosphamide with/without etoposide plus total body irradiation. One hundred seventy six transplants (98.3%) presented with infectious diseases; they occurred on the 4th through the 7th days after the transplantation and were related to average leukocyte count below 500 x 109/L and absolute neutrophil count lower than 100 x mm3. The most frequent clinical presentation was bacteremia followed by skin and mucosal infections. The most commonly isolated germs were negative coagulase staphylococci, Candida genus and Pseudomona aeruginosa. The empirical antibiotic therapy was third generation cephalosporine plus aminoglucoside plus vancomycin. The general mortality rate was 8.9 % (16 out of 179) and sepsis directly caused the death of 7 cases (43.7 %), being the higher incidence in allogenic transplants, and the Gram negative bacteria were mostly involved.


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