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Unaí Tupinambáshttp://lattes.cnpq.br/9944131333164201Helena Duanihttp://lattes.cnpq.br/1532329798133648http://lattes.cnpq.br/0448235080992266Marita de Novais Costa Salles de Almeida2022-05-04T14:16:51Z2022-05-04T14:16:51Z2019-02-21http://hdl.handle.net/1843/41367Apesar dos avanços na imunossupressão utilizada no transplante de células tronco hematopoieticas alogênico (alo-TCTH), ainda há elevado índice de doença do enxerto contra o hospedeiro aguda (DECHa), com aumento da morbimortalidade. Este estudo, analisou retrospectivamente, as causas de DECHa e sua relação com infecção da corrente sanguínea (ICS) em um hospital universitário de Minas Gerais, de 2011 a 2016. Foram incluidos 94 pacientes com mediana de idade de 35,5 anos (18-65), a maioria do sexo masculino (61,7%), submetida a alo-TCTH aparentado (81,9%) com células tronco periféricas como fonte do enxerto (81,9%). Dos pacientes, 11,7% não tiveram recuperação dos granulócitos, 91,4% tiveram algum grau de mucosite, sendo 34% de grau 2, 22,3% evoluíram para óbito em 100 dias, sendo sepse a principal causa. Em 45,7% dos pacientes foi diagnósticado ICS, 45,6% por bastonetes Gram-negativos, índice elevado em relação a países desenvolvidos, a antibioticoterapia empírica iniciada foi adequada na maioria das vezes (64,9%). Dos 34% dos pacientes diagnosticados com DECHa, 71,8% foi de grau II, sendo intestino o local mais acometido. Não foi encontrado associação entre ICS e DECHa na população estudada, o que pode ser justificado pelo tamanho da amostra analisada.Despite the notable advances in the immunosuppressive regimens used in allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the past few decades, acute graft-versus-host disease (aGVHD) is still a major complication of this procedure, with considerable associated morbidity and mortality. This was a retrospective study which aimed at analysing the possible causative factors underlying aGVHD and their relationship with blood stream infection (BSI) in adults undergoing allo-HSCT at a public university hospital in Minas Gerais, Brazil, between 2011 and 2016. A total of 94 patients were included, with a median age of 35.5 years (18-65) and a predominance of males (61.7%). Allo-HSCT from a related donor comprised 81.9% of all cases, and peripheral blood stem cells were the main source (81.9%). Among all patients, failure of neutrophil engraftment was observed in 11.7%, any grade mucositis in 91.4% (34% grade II), and death within 100 days post-transplant in 22.3%. The main cause of death was sepsis, and BSI was noted in 45.7% of cases, of which 45.6% were due to Gram-negative bacteria, a higher rate than that observed in developed countries. Empiric antimicrobial therapy was appropriate in most of the cases (64.9%). Approximately a third (34%) of all patients were diagnosed with aGVHD (71.8% grade II), with the most affected site being the gut. In this study, no association was found between BSI and aGVHD, which might be explained by the relatively small sample size of the population studied.porUniversidade Federal de Minas GeraisPrograma de Pós-Graduação em Ciências da Saúde - Infectologia e Medicina TropicalUFMGBrasilTransplante de Células-Tronco HematopoéticasTransplante de medula ósseaDoença Enxerto-HospedeiroCirculação SanguíneaDissertação AcadêmicaTransplante de células tronco hematopoiéticasDoença do enxerto contra o hospedeiro agudaTransplante de medula ósseaInfecção da corrente sanguínea.Avaliação da prevalência da doença do enxerto contra o hospedeiro aguda em pacientes submetidos a transplante alogênico de células tronco hematopoéticas e sua relação com infecção da corrente sanguínea precoce em um Hospital Universitário de Belo Horizonte - 2011 a 2016info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGORIGINALDissertação com ata pdfa.pdfDissertação com ata pdfa.pdfapplication/pdf1110267https://repositorio.ufmg.br/bitstream/1843/41367/2/Disserta%c3%a7%c3%a3o%20com%20ata%20pdfa.pdf69f8de929c49a87012cbd12eeb4175f6MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82119https://repositorio.ufmg.br/bitstream/1843/41367/3/license.txt34badce4be7e31e3adb4575ae96af679MD531843/413672022-05-04 11:16:51.905oai:repositorio.ufmg.br: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Repositório InstitucionalPUBhttps://repositorio.ufmg.br/oaiopendoar:2022-05-04T14:16:51Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
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