Späte infektiöse Komplikationen nach Hochdosistherapie und autologer Blutstammzelltransplantation

Metzner, Bernd; Grüneisl, Ricarda; Gebauer, Wolfgang; Reschke, Daniel; Ost, E.; Müller, Thomas H.; Reichert, Dietmar; Rosien, Bernd; Valle, Francisco del; Zirpel, I.; Kohse, Klaus P.; Schunter, F.

doi:10.1007/s00063-002-1208-y

Medizinische Klinik

2002

DOI: 10.1007/s00063-002-1208-y

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Späte infektiöse Komplikationen nach Hochdosistherapie und autologer Blutstammzelltransplantation

Bernd Metzner

Ricarda Grüneisl

Wolfgang Gebauer

et al.

Abstract: Significant late infectious complications after ASCT are uncommon. Patients with hematologic malignancies have a significantly increased risk of more serious infections and should be observed carefully. For risk patients with hematologic malignancies and possibly solid tumors, a strict PcP prophylaxis is required. Patients with relapsed lymphomas could possibly be treated preventively against zoster with low-dose aciclovir to reduce the extent of zoster disease. Each patient should be informed carefully that e… Show more

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Cited by 2 publications

References 26 publications

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Immune Deficits in Allogeneic Hematopoietic Stem Cell Transplant (HSCT) Recipients

Mir

Battiwalla

2009

Mycopathologia

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Immune deficits account for the high frequency of life threatening bacterial, viral, and fungal opportunistic infections seen in allogeneic HSCT recipients. Despite advances in infectious disease management, the integrity of host defenses remains the mainstay of defense. The intensity of the preparative regimen, degree of HLA matching, source of stem cells (marrow, blood, or cord), extent of T-cell depletion, and immunosuppressive therapy are some of the factors that impact the kinetics, characteristics, and quality of immune reconstitution. Graft-versus-host disease and its prophylaxis or treatment produce a host environment that is particularly vulnerable to infections. Mucosal disruption and prolonged severe neutropenia usually confine their impact to the early course of transplant. After initial engraftment, HSCT recipients remain at great risk for opportunistic infections and this is related to prolonged and severe T-lymphocyte dysfunction of a complex multifactorial nature. B cell dysfunction is less problematic clinically, but includes deficiencies of immunoglobulin subclasses and impaired ability to mount a vaccine response. Advances in understanding of these immune deficits have resulted in successful strategies including revaccination, growth factors, thymic protection, and adoptive cellular therapy with antigen-specific cells.

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Immune Deficits in Allogeneic Hematopoietic Stem Cell Transplant (HSCT) Recipients

Mir

Battiwalla

2009

Mycopathologia

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Herpes zoster prophylaxis with low‐dose acyclovir in patients with malignant lymphoma and multiple myeloma treated with autologous stem cell transplantation

Abbasov

Metzner

Müller

et al. 2022

European J of Haematology

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Background Herpes zoster (HZ) is a frequent complication after autologous stem cell transplantation (ASCT). The option of zoster prophylaxis with an antiviral drug is described in the literature, but there is no consensus on the drug and the dosage. Patients and Methods We analyzed the records of 310 patients treated with ASCT who were controlled regularly regarding HZ inter alia for at least 24 months following ASCT. Since 01/2015 patients received prophylactic low‐dose acyclovir (400 mg per day) during the first 12 months following discharge after ASCT (n = 107). Results Twenty percent of patients without this kind of prophylaxis and 2.8% of patients with prophylaxis developed HZ (p < .001). No patient with this prophylaxis developed HZ in the first year after ASCT, 2.8% of patients in the second year after ASCT. A prognostic factor was the kind of diagnosis: 30% of lymphoma patients and 14% of myeloma patients developed HZ in the first 24 months after ASCT without prophylaxis, but only 6.3% and 0% of patients with prophylaxis, respectively. Neither an increase of HZ cases following prophylaxis nor acyclovir refractory HZ cases were observed. Conclusions Zoster prophylaxis with low‐dose acyclovir over 12 months after ASCT is effective and well tolerated.

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Späte infektiöse Komplikationen nach Hochdosistherapie und autologer Blutstammzelltransplantation

Cited by 2 publications

References 26 publications

Immune Deficits in Allogeneic Hematopoietic Stem Cell Transplant (HSCT) Recipients

Immune Deficits in Allogeneic Hematopoietic Stem Cell Transplant (HSCT) Recipients

Herpes zoster prophylaxis with low‐dose acyclovir in patients with malignant lymphoma and multiple myeloma treated with autologous stem cell transplantation

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