Richards J M, Gilewski T A, Vogelzang N J
Department of Medicine, University of Chicago, Illinois.
Cancer. 1991 Mar 15;67(6):1570-5. doi: 10.1002/1097-0142(19910315)67:6<1570::aid-cncr2820670619>3.0.co;2-v.
The authors prospectively monitored patients undergoing leukapheresis for peripheral stem cell harvesting (PSCH) or lymphokine activated killer (LAK) cell generation for 3 weeks after catheter placement for evidence of local or systemic infections. Over a 1-year period, 16 patients underwent leukapheresis for PSCH in preparation for autologous bone marrow transplantation (ABMT). The original catheters remained in place an average of 20 days without any documented infections. Seventeen patients underwent leukapheresis as part of a low-dose interleukin-2 (IL-2) treatment for LAK cell generation, and their catheters remained in place an average of 20.2 days with three documented episodes of bacteremia (18%). Eight patients treated with high-dose IL-2 also underwent leukapheresis for LAK cell generation and their catheters remained in place an average of 12 days with three documented episodes of bacteremia (38%). In all cases of bacteremia, Staphylococcus species were isolated from the blood. The IL-2 exposure level was associated with the risk of bacteremia (P = 0.01). Other potential risk factors (e.g., number of pheresis procedures, complement level, serum immunoglobulin levels, absolute neutrophil count) were not related to this risk.
作者前瞻性地监测了接受白细胞单采术以采集外周干细胞(PSCH)或生成淋巴因子激活的杀伤细胞(LAK)的患者,在置管后3周内观察局部或全身感染的证据。在1年的时间里,16例患者接受白细胞单采术以进行PSCH,为自体骨髓移植(ABMT)做准备。原始导管平均留置20天,无任何记录在案的感染。17例患者接受白细胞单采术作为低剂量白细胞介素-2(IL-2)治疗以生成LAK细胞的一部分,他们的导管平均留置20.2天,有3例记录在案的菌血症发作(18%)。8例接受高剂量IL-2治疗的患者也接受白细胞单采术以生成LAK细胞,他们的导管平均留置12天,有3例记录在案的菌血症发作(38%)。在所有菌血症病例中,均从血液中分离出葡萄球菌属。IL-2暴露水平与菌血症风险相关(P = 0.01)。其他潜在风险因素(如单采程序次数、补体水平、血清免疫球蛋白水平、绝对中性粒细胞计数)与该风险无关。