Low infectious morbidity in patients with heavily pretreated hematological malignancies receiving autologous peripheral blood stem cell transplantation without antimicrobial prophylaxis

The use of prophylactic antimicrobials during autologous peripheral blood stem cell transplantation (APBSCT) remains controversial. A prospective study was therefore conducted to examine whether the use of prophylactic antimicrobials is necessary. In this study, all the antimicrobials were given therapeutically rather than prophylactically. Twenty-three consecutive patients with heavily pretreated hematological malignancies were enrolled. All of the 23 patients had at least one episode of fever during APBSCT and most were fever of unknown origin (78.3%). Clinically or microbiologically documented infections occurred in only five patients (21.7%). These included bacteremias (three patients), perianal abscess (one patient), and catheter-related phlebitis (one patient). No death, invasive fungal infection, or serious adverse events occurred. The medium duration of fever, intravenous antimicrobial therapy, and hospital stay after transplantation were 5, 10, and 17 days, respectively. In conclusion, without using prophylactic antimicrobials, the infectious morbidity during APBSCT is low even in patients with heavily pretreated hematological malignancies.