Gang A O, Arpi M, Gang Uffe J O, Vangsted A J
Center for Cancer Immune Therapy, Department of Haematology, Herlev University Hospital, Copenhagen, Denmark.
Hematology. 2010 Aug;15(4):222-9. doi: 10.1179/102453309X12583347113979.
Infections are life-threatening complications in patients undergoing high-dose chemotherapy with stem cell support (HDT). Knowledge of the infectious pathogens is essential to make a safe outpatient setting.
We conducted a retrospective study of 208 patients treated with HDT. The population included non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) patients. No patients received prophylactic antibacterial treatment.
Pathogens were isolated from 44% of all patients. MM patients more frequently had multiple pathogens in blood cultures (38% versus 25%). Transplantation related mortality was similar between the groups.
The frequency of isolated pathogens, positive blood cultures, and the diversity of pathogens were higher in MM patients as compared to NHL patients. However, this did not translate into higher transplantation-related mortality, probably because broad-spectrum antibiotic treatment could be initiated immediately. A safe outpatient setting with prophylactic antibiotic treatment is dependent on continuous collection and registration of microbiological findings.
感染是接受大剂量化疗并伴有干细胞支持（HDT）的患者面临的危及生命的并发症。了解感染病原体对于建立安全的门诊治疗环境至关重要。
我们对208例接受HDT治疗的患者进行了一项回顾性研究。研究人群包括非霍奇金淋巴瘤（NHL）和多发性骨髓瘤（MM）患者。没有患者接受预防性抗菌治疗。
44%的患者分离出病原体。MM患者血培养中出现多种病原体的频率更高（38%对25%）。两组的移植相关死亡率相似。
与NHL患者相比，MM患者分离出病原体的频率、血培养阳性率和病原体多样性更高。然而，这并未转化为更高的移植相关死亡率，可能是因为可以立即开始使用广谱抗生素治疗。采用预防性抗生素治疗的安全门诊治疗环境依赖于微生物学结果的持续收集和记录。
