engleski

Antimicrobial prophylaxis in hematopoietic stem cell transplant recipients

Introduction Infections are common complications of hematopoietic stem cell transplantation (HSCT), which compromise this therapeutical method for hematologic malignancies. A variety of microbial agents can induce potentially lethal disease during distinct phases of transplantation. Antimicrobial agents are commonly used prophylactically after HSCT to prevent bacterial, viral and fungal infections. Discussion One of the major risk factors for infection include host factors, type of transplant (allogeneic vs autologous, peripheral blood vs bone marrow), immunosuppressive regimen, and graft reactions. Patients undergoing allogeneic stem cell transplantation are highly susceptible for acquisition and reactivation of infectious diseases. The risk of infection is primarly determined by the time from transplant and the presence or absence of graft versus host disease (GVHD). Compared with patients undergoing autologous transplantation, patients undergoing allogeneic transplantation are at a greater risk of infection because of a longer time to achieve engraftment (prolonged neutropenia) and prolonged process for lymphocyte recovery which requires several months. The susceptibility of the host for infections is influenced by the underlying disease including preceding courses of antineoplastic therapy, the intensity of conditioning regimen and regimen related toxicity, and the degree of human leukocyte antigen (HLA)-compatibility between stem cell donor and recipient. Conclusion Prompt isolation and identification of microbial agent, especially in blood, the establishment of an adequate antimicrobial therapy can significantly contribute to the more successful treatment of infections in transplanted patients.

transplantation; hematopoietic stem cell; antimicrobial prophylaxis

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