[Complications and management of hematopoietic malignancy therapy]

Infection and refractoriness to platelet transfusion, as complications in hematopoietic malignancy therapy, were investigated. The Hanshin Study Group of Hematopoietic Disorders and Infection treated with 3,346 cases of bacterial infection (7.8% sepsis, 71% sepsis suspected, 13.7% respiratory infection) during the past 13 years. A total of 688 strains were detected as causative organisms, 59.2% being gram-negative bacilli and 40.3% gram-positive bacteria. Comparison of the detection rates obtained 10 years ago and those obtained in the last three years showed a decrease from 73.8% to 46.8% for gram-negative bacilli and an increase from 25.1% to 53.2% for gram-positive bacteria. Twenty-eight antibiotics administered singly and nine combinations of two drugs administered concomitantly were assessed. Efficacy rates were 43.9% to 67.2% for single-drug administration and 35.2% to 64.2% for concomitant administration. Notably, some combinations were less effective than single-drug administration. Of 153 cases of fungal infection seen in the last three years, 80% were caused by the genus Candida. Two antifungal drugs were used, with efficacy rates ranging from 45.5% to 70.0%. In 150 patients undergoing frequent transfusion, anti-HLA alloantibody was measured. The positive rate was 32.9%. In 76 subjects receiving leukocyte-depleted platelet transfusion using a polyester filter, a decreased alloantibody positive rate of 17.1% was obtained.