Guidelines for preventing infectious complications among hematopoietic cell transplant recipients: a global perspective PREFACE

Department of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN, USA.
Bone marrow transplantation (Impact Factor: 3.57). 10/2009; 44(8):453-5. DOI: 10.1038/bmt.2009.254
Source: PubMed

ABSTRACT infection, prevention, guidelines

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    • "For patients with hematologic malignancies, the prevalence of HBV screening increased dramatically during period 1, which included the FDA letter. This increase may be related to the high risk (nearly 50%) of reactivation [16] and frequent reports of reactivation among patients with hematologic malignancies [17-19] and to the frequent reports of reactivation among patients receiving rituximab [20-24]. The further increase in screening prevalence during periods 2 and 3 was likely due to the emphasis in national recommendations on the risk of HBV reactivation in these patients. "
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    ABSTRACT: National organizations recommend screening for hepatitis B virus (HBV) before chemotherapy but differ regarding which patients should be screened. We aimed to determine contemporary screening rates at a cancer center and the possible influence on these rates of publication of national recommendations. We conducted a retrospective cohort study of HBV screening in cancer patients registered during the period from January 2004 through April 2011. Screening was defined as HBsAg and anti-HBc tests ordered around the time of initial chemotherapy. We compared screening rates for 3 periods: January 1, 2004, through December 18, 2008 (Food and Drug Administration and American Association for the Study of Liver Diseases 2007 recommendations); December 19, 2008, through September 30, 2010 (Centers for Disease Control and Prevention, National Comprehensive Cancer Network, American Association for the Study of Liver Diseases 2009, Institute of Medicine, and American Society of Clinical Oncology recommendations); and October 1, 2010, through April 30, 2011. Logistic regression models were used to identify predictors of screening. Of 141,877 new patients, 18,688 received chemotherapy, and 3020 (16.2%) were screened. HBV screening rates increased over the 3 time periods (14.8%, 18.2%, 19.9%; P < 0.0001), but <19% of patients with HBV risk factors were screened. Among patients with hematologic malignancies, over 66% were screened, and odds of screening nearly doubled after publication of the recommendations (P < 0.0001). Less than 4% of patients with solid tumors were screened, although odds of screening increased 70% after publication of the recommendations (P = 0.003). Other predictors of screening included younger age, planned rituximab therapy, and known risk factors for HBV infection. Most patients with solid tumors or HBV risk factors remained unscreened, although screening rates increased after publication of national recommendations. Efforts are needed to increase awareness of the importance of HBV screening before chemotherapy to identify patients who should start antiviral prophylaxis.
    BMC Cancer 11/2013; 13(1):534. DOI:10.1186/1471-2407-13-534 · 3.36 Impact Factor
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    ABSTRACT: On the basis of personal experience, the microbiological, epidemiological, clinical and therapeutic features of Pneumocystis carinii pneumonia are analysed.
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