A review of infectious complications after haploidentical hematopoietic stem cell transplantations

Background Allogeneic hematopoietic stem cell transplantation from haploidentical donor is a feasible option for patients with hematological diseases who lack a suitable HLA-matched donor, but viral and fungal infections are still the most common causes of morbidity and mortality in haploidentical t...

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Bibliographic Details
Published in:Infection 2017-08, Vol.45 (4), p.403-411
Main Authors: Atilla, Erden, Atilla, Pinar Ataca, Bozdağ, Sinem Civriz, Demirer, Taner
Format: Article
Language:English
Subjects:
Bacteria
Bacterial Infections - epidemiology
Bacterial Infections - microbiology
Cord blood
Cyclophosphamide
Documents
Family Medicine
Fungal infections
Fungi
General Practice
Graft-versus-host reaction
Hematological diseases
Hematopoietic Stem Cell Transplantation - adverse effects
Histocompatibility antigen HLA
Humans
Immune reconstitution
Incidence
Infectious Diseases
Internal Medicine
Lymphocytes
Lymphocytes T
Medicine
Medicine & Public Health
Morbidity
Mycoses - epidemiology
Mycoses - microbiology
Neutropenia
Patients
Prophylaxis
Review
Risk analysis
Risk Factors
Rope
Search methods
Stem cell transplantation
Stem cells
Steroids
Transplantation
Transplants & implants
Viral infections
Virus Diseases - epidemiology
Virus Diseases - virology
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Description
Summary:Background Allogeneic hematopoietic stem cell transplantation from haploidentical donor is a feasible option for patients with hematological diseases who lack a suitable HLA-matched donor, but viral and fungal infections are still the most common causes of morbidity and mortality in haploidentical transplantation setting because of delayed immune reconstitution, increased risk of graft vs host disease (GvHD) or systemic steroid use. Therefore, this review will focus on the infectious complications after haploidentical hematopoietic stem cell transplantation (HSCT). Materials and methods Electronic publications were searched until February 2017 throughout databases, including Pubmed, Cochrane, and Embase. The following keywords were used ‘haploidentical transplantation’, ‘infection’, ‘T cell replete’, and ‘T cell deplete’. Results An increased incidence of bacterial, fungal, or viral infections is detected in haplo-HSCT compared to related, unrelated, or cord blood transplantations. Neutropenia and use of systemic steroid for GvHD and delayed immune reconstitution are important risk factors for infection after haplo-HSCT. Conclusion A shift towards T cell repletes haplo-HSCT with post-transplant cyclophosphamide (CY) for GvHD has been emerged in recent years, in which the incidence of viral and fungal infections is detected to be lower. Prophylaxis and pre-emptive treatment strategies should be applied according to patient status.
ISSN:0300-8126
1439-0973
DOI:10.1007/s15010-017-1016-1