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[Infectious complications in bone marrow transplantation].
M T Gómez Casares1, M J Alsar, E Conde
1Servicios de Hematología, Hospital Universitario Marqués de Valdecilla, Facultad de Medicina, Universidad de Cantabria, Santander.
Medicina Clinica
|March 23, 1991
Summary
Infections are a major complication following bone marrow transplants (BMT), with bacteria being the most common cause. Pneumonia significantly increases mortality, while sepsis has a lower mortality rate.
Area of Science:
- Hematology
- Infectious Diseases
- Oncology
Background:
- Bone marrow transplantation (BMT) is associated with significant infectious complications.
- Evaluating the incidence and causative organisms of infections post-BMT is crucial for patient management.
Purpose of the Study:
- To determine the incidence and types of infections in patients undergoing bone marrow transplantation (BMT).
- To identify the organisms responsible for these infections and analyze their impact on patient outcomes.
Main Methods:
- Retrospective analysis of 194 febrile episodes in 115 BMT patients between 1980 and 1987.
- Categorization of febrile episodes into three periods: marked neutropenia, up to 100 days post-BMT, and beyond 100 days.
Main Results:
- Infections were confirmed in 62% of febrile episodes, with bacteria being the most frequent cause (73%).
- Pneumonia had a high mortality rate (54%), whereas sepsis had a low mortality rate (6%).
- Gram-negative bacteria predominated in early neutropenic periods, while Gram-positive bacteria were more common later.
Conclusions:
- Infection is a major BMT complication, necessitating effective antimicrobial strategies.
- Pneumonia is the most lethal infection post-BMT, while sepsis is less so.
- Graft-versus-host disease increases the risk of infection in allogeneic BMT recipients.