scholarly journals Two Person Dressing Change Team to Prevent Central Line-Associated Bloodstream Infections (CLABSI) in a Stem Cell Transplant Unit at a Tertiary Medical Center

2020 ◽  
Vol 26 (3) ◽  
pp. S82
Author(s):  
Shannon Hunger ◽  
Kristen Van Scoyoc ◽  
Tacia Bullard ◽  
Mary Beth Kukla ◽  
Mary Beth Davis
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplant ◽  
Medical Center ◽  
Bloodstream Infections ◽  
Central Line ◽  
Cell Transplant ◽  
Change Team ◽  
Dressing Change

scholarly journals Moving CLABSI Prevention beyond the Intensive Care Unit: Risk Factors in Pediatric Oncology Patients

2011 ◽  
Vol 32 (11) ◽  
pp. 1079-1085 ◽  
Author(s):  
Matthew Kelly ◽  
Margaret Conway ◽  
Kathleen Wirth ◽  
Gail Potter-Bynoe ◽  
Amy L. Billett ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
Pediatric Oncology ◽  
Stem Cell Transplant ◽  
Conditional Logistic Regression ◽  
Bloodstream Infections ◽  
Central Line ◽  
Cell Transplant ◽  
Retrospective Case ◽  
Oncology Patients

Background and Objective.Central line-associated bloodstream infections (CLABSIs) frequently complicate the use of central venous catheters (CVCs) among pediatric patients with cancer. Our objectives were to describe the microbiology and identify risk factors for hospital-onset CLABSI in this patient population.Design.Retrospective case-control study.Setting.Oncology and stem cell transplant units of a freestanding, 396-bed quaternary care pediatric hospital.Participants.Case subjects (N= 54) were patients with a diagnosis of malignancy and/or stem cell transplant recipients with CLABSI occurring during admission. Controls (N= 108) were identified using risk set sampling of hospitalizations among patients with a CVC, matched on date of admission.Methods.Multivariate conditional logistic regression was used to identify independent predictors of CLABSI.Results.The majority of CLABSI isolates were gram-positive bacteria (58%). The most frequently isolated organism wasEnterococcus faecium, and 6 of 9 isolates were resistant to vancomycin. In multivariate analyses, independent risk factors for CLABSI included platelet transfusion within the prior week (odds ratio [OR], 10.90 [95% confidence interval (CI), 3.02-39.38];P<.001) and CVC placement within the previous month (<1 week vs ≥1 month: OR, 11.71 [95% CI, 1.98-69.20];P= .02; ≥1 week and <1 month vs ≥1 month: OR, 7.37 [95% CI, 1.85-29.36];P= .004).Conclusions.Adjunctive measures to prevent CLABSI among pediatric oncology patients may be most beneficial in the month following CVC insertion and in patients requiring frequent platelet transfusions. Vancomycin-resistant enterococci may be an emerging cause of CLABSI in hospitalized pediatric oncology patients and are unlikely to be treated by typical empiric antimicrobial regimens.

Efficacy of a conversion from filgrastim to filgrastim-sndz in stem cell transplant patients undergoing mobilization

2020 ◽  
pp. 107815522094158
Author(s):  
Lauren D Curry ◽  
Brandi Anders ◽  
Emily V Dressler ◽  
LeAnne Kennedy
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplant ◽  
Medical Center ◽  
Hematopoietic Cells ◽  
The United States ◽  
Similar Efficacy ◽  
Median Number ◽  
Autologous Stem Cell Transplant ◽  
Cell Transplant ◽  
Biosimilar Product

During autologous stem cell transplant, granulocyte colony-stimulating factors (G-CSF) serve the integral role of mobilizing hematopoietic cells into the peripheral blood for subsequent collection by leukapheresis. Filgrastim (Neupogen®) is a G-CSF and affects hematopoietic cells by stimulating growth and differentiation of neutrophils. Filgrastim-sndz (Zarxio®), a biosimilar of filgrastim, received landmark approval as the first biosimilar product approved by the FDA in the United States. As a result of the recent FDA approval, our medical center made the conversion in August 2016 from using filgrastim to filgrastim-sndz to provide patients the same benefits of the filgrastim injection at a reduced cost. This retrospective, observational cohort study evaluated the comparative efficacy of the filgrastim-sndz biosimilar in 147 patients who underwent mobilization prior to stem cell transplant with filgrastim between 1 August 2015 and 31 July 2016 or filgrastim-sndz between 1 September 2016 and 30 November 2017. The mean number of CD34 cells collected during apheresis was 7.38 × 106 in the filgrastim group and 8.86 × 106 in the filgrastim-sndz group. Filgrastim-sndz was significantly non-inferior, as the difference between filgrastim and filgrastim-sndz was −1.48 × 106 with an upper 95% confidence bound equal to −0.24 × 106 that did not include the non-inferiority margin of 1 × 106 ( p = 0.0006). The median number of days of apheresis was 2 in both groups ( p= 0.3273). In conclusion, the biosimilar product was non-inferior for mobilization and the conversion from filgrastim to filgrastim-sndz afforded patients similar efficacy for mobilization in stem cell transplant at a reduced cost.

Allogenic stem cell transplant in patients over the age of 70, including octogenarians, with hematologic malignancies: A single institution experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18538-e18538
Author(s):  
Robert E. Gaudet ◽  
Jan Cerny ◽  
Muthalagu Ramanathan ◽  
Glen Raffel ◽  
Zheng Zhou ◽  
...  
Keyword(s):  
Stem Cell ◽  
Treatment Modality ◽  
Stem Cell Transplant ◽  
Medical Center ◽  
Hematologic Malignancies ◽  
Cell Transplant ◽  
Single Institution ◽  
Allogenic Stem Cell Transplant ◽  
Unrelated Donors ◽  
Grade Ii

e18538 Background: Patient age is an important factor when considering allogenic stem cell transplant (aSCT) as a treatment modality for hematologic malignancies. Previous series exploring older age and outcome in aSCT have generally not included fit, older adults beyond the age of 80: a group typically considered ineligible for aSCT. This report describes our single-institution experience with aSCT in patients age 70 and older, including octogenarians, from March 2010 through April 2016. Methods: Retrospective analysis was performed on all patients older than 70 years undergoing aSCT at UMass Memorial Medical Center (UMMMC) between March 2010 and April 2016. The study was approved by the UMMMC IRB. Results: 32 patients were identified: 19 men and 13 women. 1 patient underwent a second aSCT in the study period. Median age at time of aSCT was 73 years (range 70-83). 4 patients were age >80. Diseases treated were AML (19 pts.), MDS (12 pts.), and CLL (1 pt.). 24 transplants were performed with unrelated donors: 17 with 10/10 match, 3 with 11/12 match, 3 with 10/12 match, and 1 with 9/12 match. 9 were performed with umbilical cord blood units. Grade II-IV acute GVHD developed in 9 patients (27%). Day 100 survival by age following the transplant were 11/18 (61%) for patients aged 70-75, 6/10 (60%) for patients aged 75-80 and 4/4 (100%) for patients aged 80-85. Conclusions: Allogenic Stem Cell Transplant is a viable treatment modality in highly-selected elderly patients with hematologic malignancies. Further studies are warranted in a prospective fashion. [Table: see text]

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