Early onset <28 days
Management
GI mucositis
Chemotherapy/irradiation complicated by OVS or CoNS bacteraemia
Pain killers (morphine) and antibiotics
Oesophagitis
Chemotherapy
Antacids
Herpes simplex
Antiviral prophylaxis
Candida spp.
Antifungal therapy
Gastritis
Chemotherapy/irradiation
Antacids
Neutropenic enterocolitis
Multifactorial origin
Conservative approach
High risk of candidaemia and bacteraemia with Clostridia spp. and Staph. aureus
Broad antimicrobial coverage
late onset >28 days
Management
GI mucositis
GVHD high risk of invasive fungal diseases
Start corticosteroids antifungal therapy
Colitis
Clostridium difficile
Metronidazole
CMV, adenovirus, H1N1
Antiviral treatment
Other opportunistic pathogens:
Targeted therapy
Cryptosporidium spp.
Mucorales spp.
Non–tuberculous mycobacteriae spp.
References
1.
2.
3.
Warr DG, Grunberg SM, Gralla RJ, Hesketh PJ, Roila F, Wit R, et al. The oral NK(1) antagonist aprepitant for the prevention of acute and delayed chemotherapy-induced nausea and vomiting: pooled data from 2 randomised, double-blind, placebo controlled trials. Eur J Cancer. 2005;41(9):1278–85.PubMedCrossRef
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Lopez-Jimenez J, Martin-Ballesteros E, Sureda A, Uralburu C, Lorenzo I, del Campo R, et al. Chemotherapy-induced nausea and vomiting in acute leukemia and stem cell transplant patients: results of a multicenter, observational study. Haematologica. 2006;91(1):84–91.PubMed
5.
6.
8.
Wardley AM, Jayson GC, Swindell R, Morgenstern GR, Chang J, Bloor R, et al. Prospective evaluation of oral mucositis in patients receiving myeloablative conditioning regimens and haematopoietic progenitor rescue. Br J Haematol. 2000;110(292):299.
9.
10.
Blijlevens N, Schwenkglenks M, Bacon P, D’Addio A, Einsele H, Maertens J, et al. Prospective oral mucositis audit: oral mucositis in patients receiving high-dose melphalan or BEAM conditioning chemotherapy–European Blood and Marrow Transplantation Mucositis Advisory Group. J Clin Oncol. 2008;26(9):1519–25.PubMedCrossRef
11.
McCann S, Schwenkglenks M, Bacon P, Einsele H, D’Addio A, Maertens J, et al. The Prospective Oral Mucositis Audit: relationship of severe oral mucositis with clinical and medical resource use outcomes in patients receiving high-dose melphalan or BEAM-conditioning chemotherapy and autologous SCT. Bone Marrow Transplant. 2008;43:141–7.PubMedCrossRef