Guidelines for Infection Prophylaxis, Monitoring and Therapy in Cord Blood Transplantation

Guidelines for Infection Prophylaxis, Monitoring and Therapy in Cord Blood Transplantation
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DOI:
10.1016/j.jtct.2021.01.024
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发表时间:
2021-05-05
影响因子:
3.2
通讯作者:
Hill, Joshua A.
Hill, Joshua A.
中科院分区:
医学2区
文献类型:
--
作者:
Olson, Amanda L.;Politikos, Ioannis;Hill, Joshua A.

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脐带血作为一种可供选择的干细胞来源,具有许多优点。然而,移植延迟、缺乏转移免疫以及急性移植物抗宿主病的严重发生使CB移植(CBT)受者面临感染并发症的高风险。本指南由CBT和传染病专家撰写,概述了预防和治疗接受CBT的成人患者机会性感染的循证建议。讨论的主题包括细菌,真菌,病毒,肺孢子虫和弓形虫病预防,建议PCR监测病毒,治疗CBT后最常见的感染。我们审查的关键概念,包括最近的重要作用莱特莫韦在预防CMV再激活。在缺乏数据的情况下,提供了实践建议,包括抗菌预防的持续时间。(C)2021年美国移植和细胞治疗学会。爱思唯尔公司出版All rights reserved.
As an alternative stem cell source, cord blood (CB) has many advantages. However, delayed engraftment, lack of transferred immunity, and a significant incidence of acute graft-versus-host disease renders CB transplant (CBT) recipients at high risk of infectious complications. This guidance written by CBT and infectious disease experts outlines evidence-based recommendations for the prevention and treatment of opportunistic infections in adult patients undergoing CBT. Topics addressed include bacterial, fungal, viral, pneumocystis jirovcii and toxoplasmosis prophylaxis, suggested PCR monitoring for viruses, therapy for the most commonly encountered infections after CBT. We review key concepts including the recent important role of letermovir in the prevention of CMV reactivation. In instances where there is a paucity of data, practice recommendations are provided, including the duration of antimicrobial prophylaxis. (C) 2021 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.