PREVENTION OF HEUTROPENIC FEVER DURING ADMINISTRATIOH OF HIGH DOSE VP-16 PLUS G-CSF FOR MOBIUZATION OF PBSC-THE EFACIENCY OF PROPHYLACTIC AHTlBIOTIC TREATMENT

Journal
Haematologica
Date Issued
2005-06
Author(s)
Cevreska, Lidija
Siljanoski, Nikola
Abstract
Neutropenia after high -dose VP-16 plus G-CSF, as mobilization
chemotherapy regimen prior autologous setting in
patients with hematological malignancies, is common finding,
although infectious complications have not been previously
described. In the attempt to reduce infective complications and
the higher incidence of hospitalization for neutropenic, fever
prophylactic antibiotic regimen was administered for patients
receiving this regimen. We evaluated 35 patients with lympho-proliferative
ma 19nancies (NHL13, HO 6, MM 12, and ALL 4)
treated with HOT/ASCT at Department of hematology, Skopje,
Macedonia. The patients were mobilized with VP-1 6 (2
grim') and G-CSF 10mcg/kg starting from day 5 of chemotherapy.
regimen. The regimen was effective in the progenitor cell
mobilization and almost 84% of analyzed patients reached at
least2xlO (6)/kg C034+ cells with median 3 (ranges 1-6) apheresis
procedures. Only two patients with HD and one AML failed
mobilization. The patients were divided in two groups: 1) no
specific antibiotic prophylaxis (n=7); (2) vancomycin Lv.,
cefixime p.o, (n=13); (3) amoxicillin clavulanic acid and
ciprofloxacin p.o. (n= 15), The first group of patients revealed
higher incidence of need for hospitalization (67%) due to neutropenic
fever, versus second (28%) and third group (15%) of
patients respectively (p<0,001 between the first and the other
two groups). At the end we conclude that VP-16+G-CSF mobilization
schedule revealed Significant high incidence of neutropenic
fever that can be substantially reduced by a vigorous
antimicrobial prophylactic program.
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