Frequency of infection and caused factors during transplantation in patients with multiple myeloma transplantation with autologous haematopoietic stem cell transplantation

Aim: The patients who were treated with chemotherapeutic agents for preparation regimen to perform hsct suffer from deep neutropenia and there is high risk in terms of infections. Despite using antibiotic therapy, infection risk is still increased. Infectious complications lead to increased mortality and morbidity. The first part of our study is to determine the frequency of related infections and to point out the factors of the patients who suffer from febrile neutropenia. Method: our study is a retrospective cross sectional study. Between January 1st, 2010 and December 31st, 2020, the first transplantation datas of 150 MM patients who underwent hsct in Akdeniz University Faculty of Medicine, Department of Hematology, Bone Marrow Transplantation Unit were evaluated retrospectively by scanning the transplant unit files and hospital database. Results: The data of 150 patients who underwent hsct were evaluated retrospectively. The median age of the patients at the time of transplantation was found to be 60 (35-76). 82 patients were male (55%) and 68 were female (45%). 52 of the patients (34.7%) met the criteria for PR at the time of transplant. Melfalan 200 was administered to 125 (88.3%) patients as a part of the preparation regimen. Median value of given CD 34 positive stem cell variable is 6 (2-20) x106/kg, median value of given stem cell viability is %85 (62-97), Median value of neutrophil engraftment time 10 days (5-27), median value of platelet engraftment time 12 days (8-27) and length of hospital stay was calculated as 19 days (12-38). FEN was observed in 108 patients (73%). There was no growth in the blood culture of 63% of the patients who developed FEN. The gram-positive bacteria, found in 35 people, (87,5%) is Coagulase-negative staphylococci. The most common bacterial group among Gram negative bacteria is E.coli with a rate of 40%. There was no growth in urine culture in 96 (88.9%) of 108 patients who developed FEN. The most common foci of infection were GIS (20.3%) and oral mucositis (16.5%). Piperacillin-Tazobactam and vancomycin are the most frequently preferred antimicrobial treatment types with a rate of 23.4%. The survival period was calculated as 137.1 months in patients who developed febrile neutropenia and 150.7 months in patients who did not develop FEN (p=0.313). Conclusion: FEN is a common complication after hsct, gram-positive bacteria have an important place among the causative agents. In the prevention of febrile neutropenia, prevention of oral mucositis and precision in the use of catheters are required. Keywords: Multiple Myeloma, Autologous Hematopoietic Stem Cell Transplantation, Febrile Neutropenia