Department of Hematology, Home Care and Bone Marrow Transplantation Unit, Hospital Clinic of Barcelona, Barcelona, Spain.
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Leuk Lymphoma. 2020 Jul;61(7):1565-1574. doi: 10.1080/10428194.2020.1742901. Epub 2020 Mar 25.
Despite the use of fluoroquinolone (FQ) prophylaxis, neutropenic fever (NF) is the most frequent cause of hospital readmission in ambulatory care programs for patients treated with autologous stem cell transplantation (ASCT). We analyzed the impact of intensifying primary prophylaxis with the addition of piperacillin/tazobactam (PT) to FQ. Between January 2002 and August 2018, 154 lymphoma patients conditioned with BEAM were included (40% received ceftriaxone (Ct) plus FQ and 60% PT plus FQ). NF and hospital readmission were required in 84 vs. 41% ( < .0001) and 12 vs. 1% ( = .007) of patients within the Ct and PT groups, respectively. The multivariate analysis showed that PT plus FQ retained its independent protective factor for NF (odds ratio (OR): 0.13; < .001) and for hospital readmission (OR: 0.07; = .01). The use of PT and FQ prophylaxis may effectively prevent episodes of NF and hospitalizations in lymphoma patients managed in our at-home ASCT care model.
尽管使用了氟喹诺酮（FQ）预防，但中性粒细胞减少性发热（NF）仍然是接受自体干细胞移植（ASCT）治疗的门诊护理计划中患者再次住院的最常见原因。我们分析了通过添加哌拉西林/他唑巴坦（PT）来强化原发性预防对氟喹诺酮的影响。在 2002 年 1 月至 2018 年 8 月期间，共纳入了 154 例接受 BEAM 预处理的淋巴瘤患者（40%接受头孢曲松（Ct）加 FQ，60%接受 PT 加 FQ）。在 Ct 组和 PT 组中，NF 和住院再入院的发生率分别为 84%和 41%（ < .0001）和 12%和 1%（ = .007）。多变量分析显示，PT 加 FQ 仍然是 NF（比值比（OR）：0.13； < .001）和住院再入院（OR：0.07； = .01）的独立保护因素。在我们的家庭 ASCT 护理模式中，PT 和 FQ 预防方案的使用可能有效预防淋巴瘤患者发生 NF 和住院。
