Pretransplant serum ferritin and C-reactive protein as predictive factors for early bacterial infection after allogeneic hematopoietic cell transplantation
| Autor: | Hiroshi Kawabata, Chisaki Mizumoto, Shunji Takakura, Tatsuo Ichinohe, Junya Kanda, Takatsugu Ishikawa, Kouhei Yamashita, Takashi Saito, Tadakazu Kondo, Takashi Uchiyama, Satoshi Ichiyama |
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| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Adolescent fluoroquinolone Sepsis Medicine Humans Transplantation Homologous Cumulative incidence Antibacterial agent Aged Retrospective Studies Transplantation allogeneic hematopoietic cell transplantation biology business.industry Septic shock C-reactive protein Acute-phase protein Hematopoietic Stem Cell Transplantation bacterial infection Hematology Bacterial Infections Middle Aged medicine.disease Ferritin C-Reactive Protein Immunology Ferritins biology.protein antibacterial prophylaxis Female business |
| Zdroj: | Bone marrow transplantation. 46(2):208-216 |
| ISSN: | 0268-3369 |
| Popis: | Although fluoroquinolones or other antibiotics are commonly used to prevent bacterial infections after hematopoietic cell transplantation (HCT), because of the growing presence of multidrug-resistant microorganisms, it is important to identify patients who are more likely to benefit from antibacterial prophylaxis. To evaluate risk factors for early bacterial infection after allogeneic HCT, we retrospectively analyzed clinical data for 112 consecutive adult patients with hematological malignancies who received transplants without any antibacterial prophylaxis. The cumulative incidence of bacterial infection at 30 days after transplantation was 16%. Among various pre-transplant factors, only high serum ferritin (>700 ng/mL, 47 patients) and high C-reactive protein (CRP) (>0.3 mg/dL, 28 patients) levels were significantly associated with the development of bacterial infection in a multivariate analysis (hazard ratio (95% confidence interval): ferritin, 4.00 (1.32–12.17); CRP, 3.64 (1.44–9.20)). In addition, septic shock and sepsis with organ failure were exclusively observed in patients who had high ferritin and/or high CRP levels. These results suggest that pretransplant serum ferritin and CRP levels can be useful markers for predicting the risk of early bacterial infection after allogeneic HCT. It may be prudent to limit antibacterial prophylaxis to patients with predefined risk factors to ensure the safety of HCT with the use of fewer antibiotics. |
| Databáze: | OpenAIRE |
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