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) |
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Authors: | Einsele Hermann Bertz Hartmut Beyer J?rg Kiehl Michael G Runde Volker Kolb Hans-Jochen Holler Ernst Beck Robert Schwerdfeger Rainer Schumacher Ulrike Hebart Holger Martin Hans Kienast Joachim Ullmann Andrew J Maschmeyer Georg Krüger William Niederwieser Dietger Link Hartmut Schmidt Christian A Oettle Helmut Klingebiel Thomas;Infectious Diseases Working Party of the German Society of Hematology and Oncology |
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Institution: | Dept. of Hematology, Oncology, Medical Clinic II, University of Tübingen, Otfried-Müller-Strasse 10, 72076, Tübingen, Germany. hneinsel@med.uni-tuebingen.de |
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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. |
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