Published in:
01-10-2003
Infectious complications after allogeneic stem cell transplantation: epidemiology and interventional therapy strategies
Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO)
Authors:
Hermann Einsele, Hartmut Bertz, Jörg Beyer, Michael G. Kiehl, Volker Runde, Hans-Jochen Kolb, Ernst Holler, Robert Beck, Rainer Schwerdfeger, Ulrike Schumacher, Holger Hebart, Hans Martin, Joachim Kienast, Andrew J. Ullmann, Georg Maschmeyer, William Krüger, Dietger Niederwieser, Hartmut Link, Christian A. Schmidt, Helmut Oettle, Thomas Klingebiel
Published in:
Annals of Hematology
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Special Issue 2/2003
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Abstract
The risk of infection after allogeneic stem cell transplantation is determined by the underlying disease, the intensity of previous treatments and complications that may have occurred during that time, but above all, the risk of infection is determined by the selected transplantation modality (e.g. HLA-match between the stem cell donor and recipient, T cell depletion of the graft, and others). In comparison with patients treated with high-dose chemotherapy and autologous stem cell transplantation, patients undergoing allogeneic stem cell transplantation are at a much higher risk of infection even after hematopoietic reconstitution, due to the delayed recovery of T and B cell functions. The rate at which immune function recovers after hematopoietic reconstitution greatly influences the incidence and type of post-transplant infectious complications. Infection-associated mortality, for example, is significantly higher following engraftment than during the short neutropenic period that immediately follows transplantation.