Revista de Hematología

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>Journals >Revista de Hematología >Year 2018, Issue 4

Colunga-Pedraza PR, Colunga-Pedraza JE, Bugarin-Estrada E, Yáñez-Reyes JM, Gutiérrez-Aguirre CH
Infectious complications after hematopoietic stem cell transplant
Rev Hematol Mex 2018; 19 (4)

Language: Español
References: 90
Page: 215-230
PDF: 454.37 Kb.

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The hematopoietic stem cell transplant (HSCT) is a therapeutic option for patients with hematologic malignancies and other non-malignant diseases. Infections are a major cause of morbidity in transplant patients, and are associated with high mortality rates, ranging from 8% in autologous HSCT to 20% in allogeneic HSCT. Multiple factors contribute to the increased risk of infectious diseases in patients receiving a transplant, including the age, comorbidities, conditioning scheme, HLA compatibility, the use of immunosuppressive drugs and the type of HSCT. Due to the hematopoietic and immune reconstitution taking place during the transplant, these patients are at an increased risk to acquire certain infectious agents, involving bacteria, virus and fungi. Therefore, it is important for the hematologist to know the most frequent infectious diseases in transplant patients to let proper preventive, diagnostic and therapeutic approaches.

Key words: Hematopoietic stem cell transplant, Autologous transplantation, Allogeneic transplantation.


  1. Sahin U, et al. An overview of infectious complications after allogeneic hematopoietic stem cell transplantation. J Infect Chemother 2016 Aug;22(8):505-14..

  2. Tomblyn M, et al. Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: a global perspective. Biol Blood Marrow Transplant 2009 Oct;15(10):1143-238.

  3. Atkinson K. Reconstruction of the haemopoietic and immune systems after marrow transplantation. Bone Marrow Transplant 1990 Apr;5(4):209-26.

  4. Avigan D, et al. Vaccination against infectious disease following hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2001 Mar;7(3):171-83.

  5. Ochs L, et al. Late infections after allogeneic bone marrow transplantations: comparison of incidence in related and unrelated donor transplant recipients. Blood 1995 Nov 15;86(10):3979-86.

  6. Storek J, et al. Reconstitution of the immune system after hematopoietic stem cell transplantation in humans. Semin Immunopathol 2008 Dec 24;30(4):425-37.

  7. Ogonek J, et al. Immune reconstitution after allogeneic hematopoietic stem cell transplantation. Front Immunol 2016;7(Nov):1-15.

  8. Bosch M, et al. Immune reconstitution after hematopoietic cell transplantation. Curr Opin Hematol 2012;19(4):324-55.

  9. Ljungman P, et al. Vaccination of stem cell transplant recipients: recommendations of the Infectious Diseases Working Party of the EBMT. Bone Marrow Transplant 2005 Apr 7;35(8):737-46.

  10. Cho S, et al. Infectious complications after hematopoietic stem cell transplantation: current status and future perspectives in Korea. Korean J Intern Med 2018 Mar;33(2):256–276.

  11. Wingard JR, et al. Hematopoietic stem cell transplantation: An overview of infection risks and epidemiology. Hematol Oncol Clin North Am 2011;25(1):101-16.

  12. Bachanova V, et al. Fewer infections and lower infectionrelated mortality following non-myeloablative versus myeloablative conditioning for allotransplantation of patients with lymphoma. Bone Marrow Transplant 2009 Feb 22;43(3):237-44.

  13. Rapoport BL. Management of the cancer patient with infection and neutropenia. Semin Oncol 2011 Jun;38(3):424-30.

  14. Ali N, et al. Bloodstream and central line isolates from hematopoietic stem cell transplant recipients: data from a developing country. Transpl Infect Dis 2014 Feb;16(1):98-105.

  15. Zhang W-X, et al. Febrile neutropenic infection occurred in cancer patients undergoing autologous peripheral blood stem cell transplantation. Transplant Proc 2015 Mar;47(2):523-7.

  16. Çelebi H, et al. Febrile neutropenia in allogeneic and autologous peripheral blood stem cell transplantation and conventional chemotherapy for malignancies. Bone Marrow Transplant 2000 Jul;26(2):211-4.

  17. Blennow O, et al. Incidence, risk factors, and outcome of bloodstream infections during the pre-engraftment phase in 521 allogeneic hematopoietic stem cell transplantations. Transpl Infect Dis 2014 Feb;16(1):106-14.

  18. Piñana JL, et al. Incidence, risk factors, and outcome of bacteremia following autologous hematopoietic stem cell transplantation in 720 adult patients. Ann Hematol 2014 Feb;93(2):299-307.

  19. Winston DJ, et al. Norfloxacin versus vancomycin/polymyxin for prevention of infections in granulocytopenic patients. Am J Med 1986 May;80(5):884-90.

  20. Gudiol C, et al. Etiology, clinical features and outcomes of pre-engraftment and post-engraftment bloodstream infection in hematopoietic SCT recipients. Bone Marrow Transplant 2014 Jun;49(6):824-30.

  21. Mikulska M, et al. Aetiology and resistance in bacteraemias among adult and paediatric haematology and cancer patients. J Infect 2014 Apr;68(4):321-31.

  22. Cattaneo C, et al. Recent changes in bacterial epidemiology and the emergence of fluoroquinolone-resistant Escherichia coli among patients with haematological malignancies: results of a prospective study on 823 patients at a single institution. J Antimicrob Chemother 2008 Feb;61(3):721-8.

  23. Freifeld AG, et al. Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer: 2010 Update by the Infectious Diseases Society of America. Clin Infect Dis 2011 Feb;52(4):e56-93.

  24. Willems L, et al. Clostridium difficile infection after allogeneic hematopoietic stem cell transplantation: Incidence, risk factors, and outcome. Biol Blood Marrow Transplant 2012 Aug;18(8):1295-301.

  25. Lavallée C, et al. Risk factors for the development of Clostridium difficile infection in adult allogeneic hematopoietic stem cell transplant recipients: A single-center study in Québec, Canada. Transpl Infect Dis 2017 Feb;19(1):e12648.

  26. Gerding DN, et al. Clostridium difficile-associated diarrhea and colitis. Infect Control Hosp Epidemiol 1995 Aug;16(8):459-77.

  27. Alonso CD, et al. Epidemiology and outcomes of Clostridium difficile infections in hematopoietic stem cell transplant recipients. Clin Infect Dis 2012 Apr;54(8):1053-63.

  28. Alonso CD, et al. Clostridium difficile infection after adult autologous stem cell transplantation: A multicenter study of epidemiology and risk factors. Biol Blood Marrow Transplant 2013 Oct;19(10):1502-8.

  29. McDonald LC, et al. Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis 2018;66(7):987-94. matopoietic-stem-cell-transplantation-2157-7633.S3-002. php?aid=14005

  30. Aguilar-Guisado M, et al. Pneumonia in allogeneic stem cell transplantation recipients: a multicenter prospective study. Clin Transplant 2011 Nov;25(6):E629-38.

  31. Powles R, et al. Identification of patients who may benefit from prophylactic immunotherapy after bone marrow transplantation for acute myeloid leukemia on the basis of lymphocyte recovery early after transplantation. Blood 1998 May;91(9):3481-6.

  32. Engelhard D, et al. Early and late invasive pneumococcal infection following stem cell transplantation: a European Bone Marrow Transplantation survey. Br J Haematol 2002 May;117(2):444-50.

  33. Arnaout K, et al. Complications of allogeneic hematopoietic stem cell transplantation. Cancer Invest 2014;32(7):349-62.

  34. Boeckh M, et al. How I treat cytomegalovirus in hematopoietic cell transplant recipients. Blood 2009;113(23):5711- 9.

  35. Ljungman P. The role of cytomegalovirus serostatus on outcome of hematopoietic stem cell transplantation. Curr Opin Hematol 2014;21(6):466-9.

  36. Einsele H, et al. Diagnosis and treatment of cytomegalovirus 2013. Curr Opin Hematol 2014;21(6):470-5.

  37. Gabanti E, et al. Reconstitution of human cytomegalovirusspecific CD4+ T cells is critical for control of virus reactivation in hematopoietic stem cell transplant recipients but does not prevent organ infection. http://dx.doi. org/10.1016/j.bbmt.2015.08.002

  38. Mori T, et al. Cytomegalovirus infection/disease after hematopoietic stem cell transplantation. Int J Hematol 2010;91(4):588-95.

  39. Ljungman P, et al. Definitions of cytomegalovirus infection and disease in transplant recipients. Clin Infect Dis 2002 Apr 15;34(8):1094-7.

  40. Pollack M, et al. An international comparison of current strategies to prevent herpesvirus and fungal infections in hematopoietic cell transplant recipients. Biol Blood Marrow Transpl 2011;17(5):664-73.

  41. Travi G, et al. Cytomegalovirus pneumonia in hematopoietic stem cell recipients. J Intensive Care Med 2014;29(4):200-12.

  42. Boeckh M, et al. Late cytomegalovirus disease and mortality in recipients of allogeneic hematopoietic stem cell transplants : importance of viral load and T-cell immunity. Transplantation 2003;101(2):407-14.

  43. Vigil KJ, et al. Analytic review: Viral pneumonias in immunocompromised adult hosts. J Intensive Care Med 2010;25(6):307-26.

  44. Reddy SM, et al. CMV central nervous system disease in stem-cell transplant recipients: An increasing complication of drug-resistant CMV infection and protracted immunodeficiency. Bone Marrow Transplant 2010 Jun;45(6):979-84.

  45. Eid AJ, et al. Clinical features and outcomes of cytomegalovirus retinitis after transplantation. Transpl Infect Dis 2008 Feb;10(1):13-8.

  46. Dumont LJ, et al. The effect of leukocyte-reduction method on the amount of human cytomegalovirus in blood products: A comparison of apheresis and filtration methods. Blood 2001;97(11):3640-7.

  47. Schmidt GM, et al. A randomized, controlled trial of prophylactic ganciclovir for cytomegalovirus pulmonary infection in recipients of allogeneic bone marrow transplants; The City of Hope-Stanford-Syntex CMV Study Group. N Engl J Med 1991;324(15):1005-11.

  48. Zaia J, et al. Viral disease prevention after hematopoietic cell transplantation. Bone Marrow Transplant 2009 Oct;44(8):471-82.

  49. Ayala E, et al. Valganciclovir is safe and effective as preemptive therapy for CMV infection in allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2006;37(9):851-6.

  50. Reusser P, et al. Randomized multicenter trial of foscarnet versus ganciclovir for preemptive therapy of cytomegalovirus infection after allogeneic stem cell transplantation. Blood 2002;99(4):1159-64.

  51. Lindemans CA, et al. How I treat adenovirus in hematopoietic stem cell transplant recipients. Blood 2010 Dec 16;116(25):5476-85.

  52. Ramaprasad C, et al. Infectious complications of stem cell transplantation. In: Cancer treatment and research. 2014;351-70.

  53. Taniguchi K, et al. Incidence and treatment strategy for disseminated adenovirus disease after haploidentical stem cell transplantation. Ann Hematol 2012 Aug 3;91(8):1305- 12.

  54. La Rosa AM, et al. Adenovirus Infections in adult recipients of blood and marrow transplants. Clin Infect Dis 2001 Mar 15;32(6):871-6.

  55. Symeonidis N, et al. Invasive adenoviral infections in T-celldepleted allogeneic hematopoietic stem cell transplantation: high mortality in the era of cidofovir. Transpl Infect Dis 2007 Jun;9(2):108-13.

  56. Schmidt-Hieber M, et al. Viral encephalitis after allogeneic stem cell transplantation: a rare complication with distinct characteristics of different causative agents. Haematologica. Ferrata Storti Foundation; 2011 Jan;96(1):142-9.

  57. van Tol MJD, et al. Adenovirus infection in paediatric stem cell transplant recipients: increased risk in young children with a delayed immune recovery. Bone Marrow Transplant 2005 Jul 23;36(1):39-50.

  58. Styczynski J, et al. Management of HSV, VZV and EBV infections in patients with hematological malignancies and after SCT: guidelines from the Second European Conference on Infections in Leukemia. Bone Marrow Transplant. Nature Publishing Group; 2009 May 1;43(10):757-70.

  59. Pranab Sharma Acharya SK. Infectious Complications of Hematopoietic Stem Cell Transplantation. J Stem Cell Res Ther [Internet]. 2013;s3(1). Available from: https:// www.omicsonline.org/infectious-complications-of-he

  60. Erard V, et al. Use of long‐term suppressive acyclovir after hematopoietic stem‐cell transplantation: Impact on herpes simplex virus (HSV) disease and drug‐resistant HSV disease. J Infect Dis 2007 Jul 15;196(2):266-70.

  61. Gluckman E, et al. Prophylaxis of herpes infections after bone-marrow transplantation by oral acyclovir. Lancet (London, England). 1983 Sep 24;2(8352):706-8.

  62. Wade JC, et al. Oral acyclovir for prevention of herpes simplex virus reactivation after marrow transplantation. Ann Intern Med 1984 Jun;100(6):823-8.

  63. Blennow O, et al. Varicella-zoster reactivation after allogeneic stem cell transplantation without routine prophylaxis— The incidence remains high. Biol Blood Marrow Transplant 2014 Oct 1;20(10):1646-9.

  64. Steer C, et al. Varicella-zoster infection after allogeneic bone marrow transplantation: incidence, risk factors and prevention with low-dose aciclovir and ganciclovir. Bone Marrow Transplant 2000 Mar 13;25(6):657-64.

  65. Peritz DC, et al. Visceral varicella zoster virus (VZV) after allogeneic hematopoietic stem cell transplant (HSCT) in pediatric patients with chronic graft-versus-host disease (cGVHD). J Pediatr Hematol Oncol 2008 Dec;30(12):931-4.

  66. Boeckh M, et al. Long-term acyclovir for prevention of varicella zoster virus disease after allogeneic hematopoietic cell transplantation--a randomized double-blind placebocontrolled study. Blood 2006 Mar 1;107(5):1800-5.

  67. Gustafsson A, et al. Epstein-Barr virus (EBV) load in bone marrow transplant recipients at risk to develop posttransplant lymphoproliferative disease: prophylactic infusion of EBV-specific cytotoxic T cells. Blood 2000 Feb 1;95(3):807-14.

  68. Uhlin M, et al. Risk factors for Epstein-Barr virus-related post-transplant lymphoproliferative disease after allogeneic hematopoietic stem cell transplantation. Haematologica. Ferrata Storti Foundation 2014 Feb;99(2):346–52.

  69. Aalto SM, et al. Epstein-Barr Viral Load and Disease Prediction in a Large Cohort of Allogeneic Stem Cell Transplant Recipients. Clin Infect Dis. Oxford University Press; 2007 Nov 15;45(10):1305-9.

  70. Meerbach A, et al. Monitoring of Epstein-Barr virus load after hematopoietic stem cell transplantation for early intervention in post-transplant lymphoproliferative disease. J Med Virol 2008 Mar;80(3):441-54.

  71. Erard V, et al. BK Virus infection in hematopoietic stem cell transplant recipients: frequency, risk factors, and association with postengraftment hemorrhagic cystitis. Clin Infect Dis 2004 Dec 15;39(12):1861-5.

  72. Dropulic LK, et al. Polyomavirus BK infection in blood and marrow transplant recipients. Bone Marrow Transplant 2008 Jan;41(1):11-8.

  73. Leung AY, et al. Quantification of polyoma BK viruria in hemorrhagic cystitis complicating bone marrow transplantation. Blood 2001 Sep 15;98(6):1971-8.

  74. Savona MR, et al. Low-dose cidofovir treatment of BK virus-associated hemorrhagic cystitis in recipients of hematopoietic stem cell transplant. Bone Marrow Transplant 2007 Jun 16;39(12):783-7.

  75. Hovi L, et al. Invasive fungal infections in pediatric bone marrow transplant recipients: single center experience of 10 years. Bone Marrow Transplant 2000 Nov 20;26(9):999- 1004.

  76. Goodrich JM, et al. Clinical features and analysis of risk factors for invasive candidal infection after marrow transplantation. J Infect Dis 1991 Oct;164(4):731-40.

  77. Martino R, et al. Invasive fungal infections after allogeneic peripheral blood stem cell transplantation: incidence and risk factors in 395 patients. Br J Haematol 2002 Feb;116(2):475-82.

  78. Fleming S, et al. Consensus guidelines for antifungal prophylaxis in haematological malignancy and haemopoietic stem cell transplantation, 2014. Intern Med J 2014;44(12):1283-97.

  79. Walsh TJ, et al. Tratamiento de la Aspergilosis: Guías para la práctica clínica de la Sociedad de Enfermedades Infecciosas de los Estados Unidos de América (IDSA). Clin Infect Dis 2008 Feb 1;46(3):T1-36.

  80. Marr KA, et al. Invasive aspergillosis in allogeneic stem cell transplant recipients: changes in epidemiology and risk factors. Blood 2002 Dec 15;100(13):4358-66.

  81. Upton A, et al. Invasive aspergillosis following hematopoietic cell transplantation: Outcomes and prognostic factors associated with mortality. Clin Infect Dis 2007 Feb 15;44(4):531-40.

  82. Jantunen E, et al. Candidaemia in allogeneic stem cell transplant recipients: low risk without fluconazole prophylaxis. Bone Marrow Transplant 2004 Nov 2;34(10):891-5.

  83. Marr KA. Invasive Candida infections: the changing epidemiology. Oncology (Williston Park) 2004 Dec;18(14 Suppl 13):9-14.

  84. Dadar M, et al. Candida albicans - Biology, molecular characterization, pathogenicity, and advances in diagnosis and control – An update. Microb Pathog 2018 Apr;117:128-38.

  85. Cordonnier C, et al. Pneumocystis jirovecii pneumonia: still a concern in patients with haematological malignancies and stem cell transplant recipients—authors’ response. J Antimicrob Chemother 2017 Jan 25;72(4):dkw580.

  86. Monnet X, et al. Critical care management and outcome of severe Pneumocystis pneumonia in patients with and without HIV infection. Crit Care 2008;12(1):R28.

  87. Nüesch R, et al. Pneumocystis carinii Pneumonia in human immunodeficiency virus (HIV)—Positive and HIV-negative immunocompromised patients. Clin Infect Dis 1999 Dec 1;29(6):1519-23.

  88. Alanio A, et al. ECIL guidelines for the diagnosis of Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients. J Antimicrob Chemother 2016 Sep;71(9):2386-96.

  89. Stern A, et al. Prophylaxis for Pneumocystis pneumonia (PCP) in non-HIV immunocompromised patients. In: Stern A, editor. Cochrane Database of Systematic Reviews. Chichester, UK: John Wiley & Sons, Ltd; 2014.

  90. Wingard JR, et al. Randomized, double-blind trial of fluconazole versus voriconazole for prevention of invasive fungal infection after allogeneic hematopoietic cell transplantation. Blood 2010 Dec 9;116(24):5111-8.

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