  
Few infectious complications after bone marrow transplantation for breast cancer
Last Updated: 2001-02-14 10:04:41 EST (Reuters Health)
By Will Boggs, MD
WESTPORT, CT (Reuters Health) - Women who undergo bone marrow transplantation (BMT) or peripheral stem-cell transplantation (PSCT) as part of their breast cancer treatment experience few infectious complications, according to a report in the February 1st issue of Clinical Infectious Diseases.
This is the first study to address early and late infections following BMT or PSCT in women being treated for breast cancer. "Knowledge of the specific incidence and type of infections is important for planning appropriate strategies for the prevention and empiric treatment of infections," the authors explain.
Dr. Mindy G. Schuster, from the University of Pennsylvania Medical Center, in Philadelphia, and colleagues reviewed the infectious complications of 127 consecutive women who received autologous BMT or PSCT after high-dose chemotherapy for the treatment of breast cancer.
The most common infection immediately posttransplant was bacteremia caused by a variety of gram-positive and gram-negative bacteria, which occurred in 13% of patients, the authors report. This was followed by Clostridium difficile colitis and urinary tract infection, the authors report.
Most infections during hospitalization (16%) were catheter related, the researchers note, although 11% of patients developed mucocutaneous candidiasis.
Three of four deaths during transplantation were from infection, the report indicates, including one from polymicrobial sepsis and two from possible sepsis.
Among the 32 patients who experienced infections during the months after discharge, upper respiratory tract infections and dermatomal zoster dominated. Only four patients required hospitalization for infectious complications in the year of follow-up.
Viral and fungal infections, both early and late, were uncommon after these transplantations, the investigators report.
"Risks for infection complications after BMT clearly vary by underlying disease," Dr. Schuster told Reuters Health. "It may not be appropriate to extrapolate antimicrobial prevention and treatment strategies from populations who undergo BMT for different underlying diseases."
"Hopefully," Dr. Schuster added, "more formal studies will be done to evaluate risk factors for infection and develop appropriate strategies for prevention and management specifically for patients with breast cancer who undergo BMT."
Clin Infect Dis 2001;32:391-395.
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