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Article: Unique risk factors for bacteraemia in allogeneic bone marrow transplant recipients before and after engraftment

TitleUnique risk factors for bacteraemia in allogeneic bone marrow transplant recipients before and after engraftment
Authors
KeywordsAllogeneic
Bacteraemia
BMT
Risk factors
Issue Date1998
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/bmt
Citation
Bone Marrow Transplantation, 1998, v. 21 n. 11, p. 1137-1143 How to Cite?
AbstractA study of the risk factors associated with bacteraemia in 191 allogeneic bone marrow transplant (BMT) recipients (1991-1996) was performed. In contrast to risk factors commonly cited for cancer chemotherapy, mucositis, degree of conditioning toxicity of the gut and lungs, duration of neutropenia, and severity of neutropenia and monocytopenia were not associated with bacteraemia in the pre-engraftment period, during which the only significant risk factor was late stage underlying disease (P < 0.05). After engraftment, Hickman catheter infection, and severe acute and chronic graft-versus-host disease (GVHD) were found to be independently associated with bacteraemia by multivariate analysis (P < 0.001, < 0.05 and < 0.05, respectively). This might be explained by intense antimicrobial prophylaxis, early empirical treatment, and non-routine use of haemopoietic growth factors. No significant difference in mortality was detected between bacteraemic and non-bacteraemic patients in both periods. Allogeneic BMT recipients are therefore a group of patients distinct from other cancer patients receiving chemotherapy at risk of developing bacteraemia. The study findings prompt consideration of a management protocol incorporating early and routine use of haemopoietic growth factors before engraftment in high-risk patients with late stage underlying malignancies, routine antimicrobial prophylaxis for acute GVHD with intense immunosuppression, and intravenous immunoglobulin therapy for chronic GVHD. Further cost-benefit analyses are warranted.
Persistent Identifierhttp://hdl.handle.net/10722/49079
ISSN
2015 Impact Factor: 3.636
2015 SCImago Journal Rankings: 1.585
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYuen, KYen_HK
dc.contributor.authorWoo, PCYen_HK
dc.contributor.authorHui, CHen_HK
dc.contributor.authorLuk, WKen_HK
dc.contributor.authorChen, FEen_HK
dc.contributor.authorLie, AKWen_HK
dc.contributor.authorLiang, Ren_HK
dc.date.accessioned2008-06-12T06:33:57Z-
dc.date.available2008-06-12T06:33:57Z-
dc.date.issued1998en_HK
dc.identifier.citationBone Marrow Transplantation, 1998, v. 21 n. 11, p. 1137-1143en_HK
dc.identifier.issn0268-3369en_HK
dc.identifier.urihttp://hdl.handle.net/10722/49079-
dc.description.abstractA study of the risk factors associated with bacteraemia in 191 allogeneic bone marrow transplant (BMT) recipients (1991-1996) was performed. In contrast to risk factors commonly cited for cancer chemotherapy, mucositis, degree of conditioning toxicity of the gut and lungs, duration of neutropenia, and severity of neutropenia and monocytopenia were not associated with bacteraemia in the pre-engraftment period, during which the only significant risk factor was late stage underlying disease (P < 0.05). After engraftment, Hickman catheter infection, and severe acute and chronic graft-versus-host disease (GVHD) were found to be independently associated with bacteraemia by multivariate analysis (P < 0.001, < 0.05 and < 0.05, respectively). This might be explained by intense antimicrobial prophylaxis, early empirical treatment, and non-routine use of haemopoietic growth factors. No significant difference in mortality was detected between bacteraemic and non-bacteraemic patients in both periods. Allogeneic BMT recipients are therefore a group of patients distinct from other cancer patients receiving chemotherapy at risk of developing bacteraemia. The study findings prompt consideration of a management protocol incorporating early and routine use of haemopoietic growth factors before engraftment in high-risk patients with late stage underlying malignancies, routine antimicrobial prophylaxis for acute GVHD with intense immunosuppression, and intravenous immunoglobulin therapy for chronic GVHD. Further cost-benefit analyses are warranted.en_HK
dc.format.extent418 bytes-
dc.format.mimetypetext/html-
dc.languageengen_HK
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/bmten_HK
dc.relation.ispartofBone Marrow Transplantationen_HK
dc.subjectAllogeneicen_HK
dc.subjectBacteraemiaen_HK
dc.subjectBMTen_HK
dc.subjectRisk factorsen_HK
dc.titleUnique risk factors for bacteraemia in allogeneic bone marrow transplant recipients before and after engraftmenten_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0268-3369&volume=21&issue=11&spage=1137&epage=1143&date=1998&atitle=Unique+risk+factors+for+bacteraemia+in+allogeneic+bone+marrow+transplant+recipients+before+and+after+engraftmenten_HK
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hken_HK
dc.identifier.emailWoo, PCY: pcywoo@hkucc.hku.hken_HK
dc.identifier.emailLie, AKW: akwlie@HKUCC.hku.hken_HK
dc.identifier.emailLiang, R: rliang@hku.hk-
dc.identifier.authorityYuen, KY=rp00366en_HK
dc.identifier.authorityWoo, PCY=rp00430en_HK
dc.identifier.authorityLiang, R=rp00345en_HK
dc.description.naturelink_to_OA_fulltexten_HK
dc.identifier.doi10.1038/sj.bmt.1701246en_HK
dc.identifier.pmid9645577-
dc.identifier.scopuseid_2-s2.0-0031804650en_HK
dc.identifier.hkuros37091-
dc.identifier.hkuros41331-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0031804650&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume21en_HK
dc.identifier.issue11en_HK
dc.identifier.spage1137en_HK
dc.identifier.epage1143en_HK
dc.identifier.isiWOS:000073880100010-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridYuen, KY=36078079100en_HK
dc.identifier.scopusauthoridWoo, PCY=7201801340en_HK
dc.identifier.scopusauthoridHui, CH=36151687600en_HK
dc.identifier.scopusauthoridLuk, WK=7005237832en_HK
dc.identifier.scopusauthoridChen, FE=17934080100en_HK
dc.identifier.scopusauthoridLie, AKW=24284842400en_HK
dc.identifier.scopusauthoridLiang, R=26643224900en_HK
dc.customcontrol.immutablesml 130530-

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