High susceptibility to severe infectious complications at reinduction chemotherapy in patients who relapse after stem cell transplantation
| Autor: | Kunihiko Kobayashi, Akihiro Iguchi, H Naito, Yorikazu Ishikawa, T.Z. Sato, R Kobayashi, Takaaki Shikano |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Neutropenia Transplantation Conditioning Adolescent medicine.medical_treatment Graft vs Host Disease Antineoplastic Agents Infections Sepsis Immune system Recurrence Internal medicine Neoplasms Medicine Humans In patient Child Transplantation Chemotherapy business.industry Septic shock Induction chemotherapy Infant Bacterial Infections medicine.disease Surgery Child Preschool Hematologic Neoplasms Female Disease Susceptibility Stem cell business Stem Cell Transplantation |
| Zdroj: | Transplantation proceedings. 42(5) |
| ISSN: | 1873-2623 |
| Popis: | Patients who relapse after stem cell transplantation (SCT) usually appear to be liable to severe infectious complications at reinduction chemotherapy compared to patients at the first induction therapy, though this is not statistically substantiated. The aim of this study was to analyze episodes of infectious complications during reinduction chemotherapy among patients who relapsed after SCT compared with those at the first induction chemotherapy. Between February 1988 and March 2004, 145 children received SCT, and 17 (12 with hematologic malignancies and 5 with solid tumors) were enrolled as eligible subjects for this study. Positive blood cultures (sepsis) were present in six patients exclusively at the reinduction therapy but none at the first induction (P = .009). Three of the six patients progressed to septic shock. Moreover, all patients positive for blood cultures were those with hematologic malignancy (P = .007), and every patient with septic shock had received allogenic transplantation. Our results showed that reinduction chemotherapy needs attention for severe infectious complications, particularly among patients with hematologic malignancies receiving allogenic transplantations. Possible immaturity of the reconstructed systemic immune system and/or insufficient recovery of mucosal protective functions in the patients after SCT are discussed in view of their high susceptibility to severe infectious complications. |
| Databáze: | OpenAIRE |
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