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Review
. 2021 Feb;100(2):321-336.
doi: 10.1007/s00277-020-04297-8. Epub 2020 Oct 20.

Prophylaxis, diagnosis and therapy of infections in patients undergoing high-dose chemotherapy and autologous haematopoietic stem cell transplantation. 2020 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)

Maximilian Christopeit #  1 , Martin Schmidt-Hieber #  2 , Rosanne Sprute #  3   4   5 , Dieter Buchheidt  6 , Marcus Hentrich  7 , Meinolf Karthaus  8 , Olaf Penack  9 , Markus Ruhnke  10 , Florian Weissinger  11 , Oliver A Cornely #  3   4   5   12 , Georg Maschmeyer #  13
Affiliations
Review

Prophylaxis, diagnosis and therapy of infections in patients undergoing high-dose chemotherapy and autologous haematopoietic stem cell transplantation. 2020 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)

Maximilian Christopeit et al. Ann Hematol. 2021 Feb.

Abstract

To ensure the safety of high-dose chemotherapy and autologous stem cell transplantation (HDC/ASCT), evidence-based recommendations on infectious complications after HDC/ASCT are given. This guideline not only focuses on patients with haematological malignancies but also addresses the specifics of HDC/ASCT patients with solid tumours or autoimmune disorders. In addition to HBV and HCV, HEV screening is nowadays mandatory prior to ASCT. For patients with HBs antigen and/or anti-HBc antibody positivity, HBV nucleic acid testing is strongly recommended for 6 months after HDC/ASCT or for the duration of a respective maintenance therapy. Prevention of VZV reactivation by vaccination is strongly recommended. Cotrimoxazole for the prevention of Pneumocystis jirovecii is supported. Invasive fungal diseases are less frequent after HDC/ASCT, therefore, primary systemic antifungal prophylaxis is not recommended. Data do not support a benefit of protective room ventilation e.g. HEPA filtration. Thus, AGIHO only supports this technique with marginal strength. Fluoroquinolone prophylaxis is recommended to prevent bacterial infections, although a survival advantage has not been demonstrated.

Keywords: Autologous stem cell transplantation; Infection.

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Conflict of interest statement

Maximilian Christopeit reports personal fees from Merck/MSD, GILEAD, Basilea, Pfizer, IQONE, Shionogi, non-financial support and other from Robert-Koch-Institut during the conduct of the study; others from Celgene, personal fees from JAZZ, Stemline, outside the submitted work.

Martin Schmidt-Hieber has received financial support for educational meetings at the Carl-Thiem-Klinikum, Cottbus/Germany from the following companies: Janssen-Cilag, Takeda, Novartis, Pfizer, Roche, Vifor and Celgene.

Rosanne Sprute declares that she has no conflict of interest.

Dieter Buchheidt reports personal fees from Gilead Sciences, Pfizer and Merck Sharp & Dohme/Merck, outside the submitted work.

Marcus Hentrich declares that he has no conflict of interest.

Meinolf Karthaus reports personal fees from Riemser, Roche, Celgene and Servier, outside the submitted work.

Olaf Penack reports personal fees from Astellas, Merck/MSD, Shionogi, Pfizer, Omeros and grants from Incyte, outside the submitted work.

Markus Ruhnke declares that he has no conflict of interest.

Florian Weissinger reports personal fees from Roche, Novartis, Sanofi, Janssen and Pfizer, outside the submitted work.

Oliver A. Cornely is supported by the German Federal Ministry of Research and Education, is funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Germany’s Excellence Strategy—CECAD, EXC 2030—390661388 and has received research grants from Actelion, Amplyx, Astellas, Basilea, Cidara, Da Volterra, F2G, Gilead, Janssen Pharmaceuticals, Medicines Company, MedPace, Melinta Therapeutics, Merck/MSD, Pfizer and Scynexis; a consultant to Actelion, Allecra Therapeutics, Al-Jazeera Pharmaceuticals, Amplyx, Astellas, Basilea, Biosys UK Limited, Cidara, Da Volterra, Entasis, F2G, Gilead, Matinas, MedPace, Menarini Ricerche, Merck/MSD, Mylan Pharmaceuticals, Nabriva Therapeutics, Octapharma, Paratek Pharmaceuticals, Pfizer, PSI, Rempex, Roche Diagnostics Scynexis, Seres Therapeutics, Tetraphase and Vical; and received lecture honoraria from Astellas, Basilea, Gilead, Grupo Biotoscana, Merck/MSD and Pfizer.

Georg Maschmeyer reports personal fees from Gilead, Merck-Serono, Astra Zeneca and AMGEN and personal fees and non-financial support from Janssen Cilag, outside the submitted work.

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