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@ARTICLE{Klein:169981,
      author       = {E.-M. Klein and S. Sauer and S. Klein and D. Tichy$^*$ and
                      A. Benner$^*$ and U. Bertsch and J. Brandt and C. Kimmich
                      and H. Goldschmidt and C. Müller-Tidow and K. Jordan and N.
                      Giesen},
      title        = {{A}ntibiotic {P}rophylaxis or {G}ranulocyte-{C}olony
                      {S}timulating {F}actor {S}upport in {M}ultiple {M}yeloma
                      {P}atients {U}ndergoing {A}utologous {S}tem {C}ell
                      {T}ransplantation.},
      journal      = {Cancers},
      volume       = {13},
      number       = {14},
      issn         = {2072-6694},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2021-01681},
      pages        = {3439},
      year         = {2021},
      abstract     = {We compare, in this manuscript, antibiotic prophylaxis
                      versus granulocyte-colony stimulating factor (G-CSF) support
                      as anti-infective strategies, in patients with multiple
                      myeloma (MM), undergoing high-dose therapy followed by
                      autologous stem cell transplantation (HDT/ASCT). At our
                      institution, antibiotic prophylaxis after HDT/ASCT in MM was
                      stopped in January 2017 and replaced by G-CSF support in
                      March 2017. Consecutive MM patients who received HDT/ASCT
                      between March 2016 and July 2018 were included in this
                      single-center retrospective analysis. In total, 298 patients
                      and 353 individual cases of HDT/ASCT were evaluated. In
                      multivariate analyses, G-CSF support was associated with a
                      significantly shortened duration of severe leukopenia < 1/nL
                      (p < 0.001, hazard ratio (HR) = 16.22), and hospitalization
                      (estimate = -0.19, p < 0.001) compared to antibiotic
                      prophylaxis. Rates of febrile neutropenia, need of
                      antimicrobial therapy, transfer to intensive care unit, and
                      death, were similar between the two groups. Furthermore,
                      antibiotic prophylaxis was associated with a significantly
                      increased risk for the development of multidrug resistant
                      bacteria especially vancomycin-resistant Enterococcus
                      faecium compared to G-CSF support (odds ratio (OR) = 17.38,
                      p = 0.01). Stop of antibiotic prophylaxis as an
                      anti-infective strategy was associated with a reduction in
                      overall resistance rates of bacterial isolates. These
                      results indicate that G-CSF support should be the preferred
                      option in MM patients undergoing HDT/ASCT.},
      keywords     = {anti-infective strategies (Other) / antibiotic prophylaxis
                      (Other) / autologous stem cell transplantation (Other) /
                      granulocyte-colony stimulating factor (Other) / infectious
                      complications (Other) / multidrug resistant bacteria (Other)
                      / multiple myeloma (Other)},
      cin          = {C060},
      ddc          = {610},
      cid          = {I:(DE-He78)C060-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34298654},
      doi          = {10.3390/cancers13143439},
      url          = {https://inrepo02.dkfz.de/record/169981},
}