COMPARISON OF DE-ESCALATION AND NON-DE-ESCALATION EMPIRICAL THERAPY FOR CONTROLLING INFECTION IN PATIENTS WITH SEVERE APLASTIC ANEMIA TREATED WITH ANTITHYMOCYTE GLOBULIN
(Abstract release date: 05/19/16)
EHA Library. Fu R. 06/09/16; 132737; E1188
Dr. Rong Fu
Contributions
Contributions
Abstract
Abstract: E1188
Type: Eposter Presentation
Background
Aplastic anemia (AA) is a bone marrow failure syndrome, featuring pancytopenia, characterized by the reduction in hematopoietic stem and progenitor cells.combined immunosuppressive therapy (IST) with antithymocyte globulin (ATG) and cyclosporine A (CsA) is a standard first-line treatment for SAA.However, neutropenia caused by SAA and the immunosuppressive effect of ATG could increase the risk of infections.
Aims
To compare De-escalation and Non-de-escalation Empirical Therapy for Controlling Infection in Patients with Severe Aplastic Anemia Treated with Antithymocyte Globulin.
Methods
We compared the efficacy of de-escalation and non-de-escalation empirical therapy for controlling microbiological culture-confirmed infections in 87 patients with severe aplastic anemia (SAA) treated with antithymocyte globulin (ATG) from 2006 to 2015 in our center.
Results
The response rate at 7 days and 30 days in de-escalation group was significantly higher than that in non-de-escalation group (60.32% vs. 25.00%, p=0.003)(79.37% vs. 58.33%, p=0.047). After anti-infection treatment, more patients’ absolute neutrophil count(ANC) increased in de-escalation group than that in non-de-escalation (76.19% vs. 45.83%, p=0.007), though no significant difference of ANC was found between two groups. Patients in de-escalation group had better survival outcome at 90 days (p=0.003). In de-escalation group, the response rate of patients with granulocyte transfusions at 7 days was higher than that of patients without granulocyte transfusions (78.26% vs. 50%, p=0.027).
Conclusion
We concluded that early administration of broad-spectrum antibiotics pending the results of microbiological cultures combined with a commitment to change to narrow-spectrum antibiotics should be recommended for controlling infections in SAA patients treated with ATG and granulocyte transfusions might be an adjunctive therapy to improve the response rate.
Session topic: E-poster
Keyword(s): Antithymocyte globulin, Aplastic anemia, Infection
Type: Eposter Presentation
Background
Aplastic anemia (AA) is a bone marrow failure syndrome, featuring pancytopenia, characterized by the reduction in hematopoietic stem and progenitor cells.combined immunosuppressive therapy (IST) with antithymocyte globulin (ATG) and cyclosporine A (CsA) is a standard first-line treatment for SAA.However, neutropenia caused by SAA and the immunosuppressive effect of ATG could increase the risk of infections.
Aims
To compare De-escalation and Non-de-escalation Empirical Therapy for Controlling Infection in Patients with Severe Aplastic Anemia Treated with Antithymocyte Globulin.
Methods
We compared the efficacy of de-escalation and non-de-escalation empirical therapy for controlling microbiological culture-confirmed infections in 87 patients with severe aplastic anemia (SAA) treated with antithymocyte globulin (ATG) from 2006 to 2015 in our center.
Results
The response rate at 7 days and 30 days in de-escalation group was significantly higher than that in non-de-escalation group (60.32% vs. 25.00%, p=0.003)(79.37% vs. 58.33%, p=0.047). After anti-infection treatment, more patients’ absolute neutrophil count(ANC) increased in de-escalation group than that in non-de-escalation (76.19% vs. 45.83%, p=0.007), though no significant difference of ANC was found between two groups. Patients in de-escalation group had better survival outcome at 90 days (p=0.003). In de-escalation group, the response rate of patients with granulocyte transfusions at 7 days was higher than that of patients without granulocyte transfusions (78.26% vs. 50%, p=0.027).
Conclusion
We concluded that early administration of broad-spectrum antibiotics pending the results of microbiological cultures combined with a commitment to change to narrow-spectrum antibiotics should be recommended for controlling infections in SAA patients treated with ATG and granulocyte transfusions might be an adjunctive therapy to improve the response rate.
Session topic: E-poster
Keyword(s): Antithymocyte globulin, Aplastic anemia, Infection
Abstract: E1188
Type: Eposter Presentation
Background
Aplastic anemia (AA) is a bone marrow failure syndrome, featuring pancytopenia, characterized by the reduction in hematopoietic stem and progenitor cells.combined immunosuppressive therapy (IST) with antithymocyte globulin (ATG) and cyclosporine A (CsA) is a standard first-line treatment for SAA.However, neutropenia caused by SAA and the immunosuppressive effect of ATG could increase the risk of infections.
Aims
To compare De-escalation and Non-de-escalation Empirical Therapy for Controlling Infection in Patients with Severe Aplastic Anemia Treated with Antithymocyte Globulin.
Methods
We compared the efficacy of de-escalation and non-de-escalation empirical therapy for controlling microbiological culture-confirmed infections in 87 patients with severe aplastic anemia (SAA) treated with antithymocyte globulin (ATG) from 2006 to 2015 in our center.
Results
The response rate at 7 days and 30 days in de-escalation group was significantly higher than that in non-de-escalation group (60.32% vs. 25.00%, p=0.003)(79.37% vs. 58.33%, p=0.047). After anti-infection treatment, more patients’ absolute neutrophil count(ANC) increased in de-escalation group than that in non-de-escalation (76.19% vs. 45.83%, p=0.007), though no significant difference of ANC was found between two groups. Patients in de-escalation group had better survival outcome at 90 days (p=0.003). In de-escalation group, the response rate of patients with granulocyte transfusions at 7 days was higher than that of patients without granulocyte transfusions (78.26% vs. 50%, p=0.027).
Conclusion
We concluded that early administration of broad-spectrum antibiotics pending the results of microbiological cultures combined with a commitment to change to narrow-spectrum antibiotics should be recommended for controlling infections in SAA patients treated with ATG and granulocyte transfusions might be an adjunctive therapy to improve the response rate.
Session topic: E-poster
Keyword(s): Antithymocyte globulin, Aplastic anemia, Infection
Type: Eposter Presentation
Background
Aplastic anemia (AA) is a bone marrow failure syndrome, featuring pancytopenia, characterized by the reduction in hematopoietic stem and progenitor cells.combined immunosuppressive therapy (IST) with antithymocyte globulin (ATG) and cyclosporine A (CsA) is a standard first-line treatment for SAA.However, neutropenia caused by SAA and the immunosuppressive effect of ATG could increase the risk of infections.
Aims
To compare De-escalation and Non-de-escalation Empirical Therapy for Controlling Infection in Patients with Severe Aplastic Anemia Treated with Antithymocyte Globulin.
Methods
We compared the efficacy of de-escalation and non-de-escalation empirical therapy for controlling microbiological culture-confirmed infections in 87 patients with severe aplastic anemia (SAA) treated with antithymocyte globulin (ATG) from 2006 to 2015 in our center.
Results
The response rate at 7 days and 30 days in de-escalation group was significantly higher than that in non-de-escalation group (60.32% vs. 25.00%, p=0.003)(79.37% vs. 58.33%, p=0.047). After anti-infection treatment, more patients’ absolute neutrophil count(ANC) increased in de-escalation group than that in non-de-escalation (76.19% vs. 45.83%, p=0.007), though no significant difference of ANC was found between two groups. Patients in de-escalation group had better survival outcome at 90 days (p=0.003). In de-escalation group, the response rate of patients with granulocyte transfusions at 7 days was higher than that of patients without granulocyte transfusions (78.26% vs. 50%, p=0.027).
Conclusion
We concluded that early administration of broad-spectrum antibiotics pending the results of microbiological cultures combined with a commitment to change to narrow-spectrum antibiotics should be recommended for controlling infections in SAA patients treated with ATG and granulocyte transfusions might be an adjunctive therapy to improve the response rate.
Session topic: E-poster
Keyword(s): Antithymocyte globulin, Aplastic anemia, Infection
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