Document Detail


Severe sepsis in autologous stem cell transplant recipients: microbiological aetiology, risk factors and outcome.
MedLine Citation:
PMID:  18836947     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Infectious complications are the main reason for early treatment-related mortality after autologous stem cell transplantation (ASCT). We evaluated retrospectively microbiological aetiology, risk factors and clinical consequences of severe sepsis in this patient cohort. From 1996 to 2006 a total of 319 patients underwent ASCT at our institution. Antibacterial prophylaxis was not used. Neutropenic fever occurred in 83% (n=265) and was complicated by severe sepsis in 5% (n=17) of patients. Severe sepsis tended to be more common in patients with non-Hodgkin's lymphoma (NHL) than in other patients (9% vs 3%, p=0.009). Bacteraemia was observed more commonly in patients with severe sepsis (76% vs 22%, p<0.001); Pseudomonas sp. was found in 30% (n=5) of these patients. Kinetics of C-reactive protein (CRP) more commonly coincided with, rather than predicted, the development of severe sepsis. All other observed risk factors for severe sepsis (length of neutropenia, fever and blood culture findings) were late indicators. Severe sepsis was fatal in 9 patients (53%), and all had NHL (p=0.003 compared to other patients). Severe sepsis is an important cause of early mortality after ASCT, especially in NHL patients. Ways to prevent development of severe sepsis or predict its development might reduce early mortality among ASCT recipients.
Authors:
Sari Hamalainen; T Kuittinen; I Matinlauri; T Nousiainen; I Koivula; E Jantunen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Scandinavian journal of infectious diseases     Volume:  41     ISSN:  0036-5548     ISO Abbreviation:  Scand. J. Infect. Dis.     Publication Date:  2009  
Date Detail:
Created Date:  2008-12-19     Completed Date:  2009-03-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0215333     Medline TA:  Scand J Infect Dis     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  14-20     Citation Subset:  IM    
Affiliation:
Department of Medicine, Kuopio University Hospital, Kuopio, Finland. sari.hamalainen@kuh.fi
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Bacteremia / microbiology,  mortality
C-Reactive Protein / analysis
Female
Finland
Humans
Lymphoma, Non-Hodgkin / therapy*
Male
Middle Aged
Pseudomonas / isolation & purification
Pseudomonas Infections / drug therapy,  microbiology
Risk Factors
Sepsis / microbiology*,  mortality*
Stem Cell Transplantation / adverse effects*
Transplantation, Autologous / adverse effects*
Young Adult
Chemical
Reg. No./Substance:
9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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