Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Mar 21;9(3):865.
doi: 10.3390/jcm9030865.

Make Sure You Have a Safety Net: Updates in the Prevention and Management of Infectious Complications in Stem Cell Transplant Recipients

Carlos A Q Santos  1 , Yoona Rhee  1 , Michael T Czapka  1 , Aamir S Kazi  1 , Laurie A Proia  1
Affiliations
Review

Make Sure You Have a Safety Net: Updates in the Prevention and Management of Infectious Complications in Stem Cell Transplant Recipients

Carlos A Q Santos et al. J Clin Med. .

Abstract

Hematopoietic stem cell transplant recipients are at increased risk of infection and immune dysregulation due to reception of cytotoxic chemotherapy; development of graft versus host disease, which necessitates treatment with immunosuppressive medications; and placement of invasive catheters. The prevention and management of infections in these vulnerable hosts is of utmost importance and a key "safety net" in stem cell transplantation. In this review, we provide updates on the prevention and management of CMV infection; invasive fungal infections; bacterial infections; Clostridium difficile infection; and EBV, HHV-6, adenovirus and BK infections. We discuss novel drugs, such as letermovir, isavuconazole, meropenem-vaborbactam and bezlotoxumab; weigh the pros and cons of using fluoroquinolone prophylaxis during neutropenia after stem cell transplantation; and provide updates on important viral infections after hematopoietic stem cell transplant (HSCT). Optimizing the prevention and management of infectious diseases by using the best available evidence will contribute to better outcomes for stem cell transplant recipients, and provide the best possible "safety net" for these immunocompromised hosts.

Keywords: antibacterial prophylaxis; antibacterial treatment; cytomegalovirus; infectious complications; invasive fungal infections.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Leather H.L., Wingard J.R. Infections following hematopoietic stem cell transplantation. Infect. Dis. Clin. North. Am. 2001;15:483–520. doi: 10.1016/S0891-5520(05)70157-4. - DOI - PubMed
    1. Teira P., Battiwalla M., Ramanathan M., Barrett A.J., Ahn K.W., Chen M., Green J.S., Saad A., Antin J.H., Savani B.N., et al. Early cytomegalovirus reactivation remains associated with increased transplant-related mortality in the current era: A cibmtr analysis. Blood. 2016;127:2427–2438. doi: 10.1182/blood-2015-11-679639. - DOI - PMC - PubMed
    1. Green M.L., Leisenring W., Stachel D., Pergam S.A., Sandmaier B.M., Wald A., Corey L., Boeckh M. Efficacy of a viral load-based, risk-adapted, preemptive treatment strategy for prevention of cytomegalovirus disease after hematopoietic cell transplantation. Biol. Blood Marrow Transplant. 2012;18:1687–1699. doi: 10.1016/j.bbmt.2012.05.015. - DOI - PMC - PubMed
    1. Neuber S., Wagner K., Goldner T., Lischka P., Steinbrueck L., Messerle M., Borst E.M. Mutual interplay between the human cytomegalovirus terminase subunits pul51, pul56, and pul89 promotes terminase complex formation. J. Virol. 2017;91 doi: 10.1128/JVI.02384-16. - DOI - PMC - PubMed
    1. Marty F.M., Ljungman P., Chemaly R.F., Maertens J., Dadwal S.S., Duarte R.F., Haider S., Ullmann A.J., Katayama Y., Brown J., et al. Letermovir prophylaxis for cytomegalovirus in hematopoietic-cell transplantation. N. Engl. J. Med. 2017;377:2433–2444. doi: 10.1056/NEJMoa1706640. - DOI - PubMed

LinkOut - more resources