Infectious complications after allogeneic bone marrow transplantation with and without T-cell depletion of donor marrow

The infectious complications during different time intervals after allogeneic bone marrow transplantation (BMT) (day 0 to day 30, 31 to 100, 101 to 365, 366 to 730) were reviewed in 67 adult patients, 27 of whom received transplants without T-cell depletion (TCD) using methotrexate or cyclosporin A...

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Bibliographic Details
Published in:Infection 1989-05, Vol.17 (3), p.124-130
Main Authors: SCHMEISER, T, WIESNETH, M, BUNJES, D, HERTENSTEIN, B, HEIT, W, KURRLE, E
Format: Article
Language:English
Subjects:
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Bone Marrow Transplantation
Bone marrow, stem cells transplantation. Graft versus host reaction
Cohort Studies
Female
Graft Rejection
Graft vs Host Disease - complications
Graft vs Host Disease - mortality
Graft vs Host Disease - prevention & control
Humans
Immunosuppression - adverse effects
Infection - epidemiology
Infection - etiology
Infection - mortality
Lymphocyte Depletion
Male
Medical sciences
Middle Aged
T-Lymphocytes
Transfusions. Complications. Transfusion reactions. Cell and gene therapy
Transplantation, Homologous
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Summary:The infectious complications during different time intervals after allogeneic bone marrow transplantation (BMT) (day 0 to day 30, 31 to 100, 101 to 365, 366 to 730) were reviewed in 67 adult patients, 27 of whom received transplants without T-cell depletion (TCD) using methotrexate or cyclosporin A for prophylaxis of graft-versus-host disease (GvHD) and 40 of whom received donor marrow with TCD using the monoclonal anti-lymphocyte antibody campath-1 and human complement. The use of TCD reduced the incidence and severity of GvHD significantly (p less than 0.01), but was associated with an increased rate of graft rejections. During all time intervals patients with TCD had a similar, lower or statistically significantly lower number of bacterial, fungal or viral infections and a statistically significantly lower number of lethal infections (p = 0.05) as compared with patients without TCD. This finding might be explained by the fact that with TCD immunological reconstitution can take place unimpaired by GvHD or its prophylaxis or treatment, resulting in a decreased incidence of infections.
ISSN:0300-8126
1439-0973
DOI:10.1007/BF01644010