Bone marrow transplantation: current situation, complications and prevention

The Journal of Antimicrobial Chemotherapy
A E HunterN H Russell

Abstract

The number of patients undergoing BMT is rising steadily. The increase is due to a broadening of the indications for transplantation and an increase in the donor pool. There has been a progressive improvement in outcome particularly due to a fall in transplant-related mortality. Methotrexate and cyclosporin are the mainstay of graft versus host disease (GVHD) prophylaxis, but acute GVHD remains a major problem in the unrelated donor recipient. Infections remain an important cause of death and emphasise the crucial role of antimicrobial prophylaxis; death from Gram-negative sepsis has been significantly reduced by the use of prophylactic antibiotics. Fungal infections carry a high mortality, especially in allogenic transplant recipients. Fluconazole is used to protect patients in the neutropenic period and beyond in higher risk individuals. Viral infections, which may occur late, are emerging as a significant cause of morbidity and mortality in the allogeneic, particularly unrelated transplantation setting. A long term susceptibility to encapsulated bacteria suggests delayed immune reconstitution; revaccination policies are standard in most units. The longer term effects of transplantation are increasingly important with improvi...Continue Reading

Citations

Jul 19, 2002·Transplant Infectious Disease : an Official Journal of the Transplantation Society·G R De La RosaD P Kontoyiannis
Aug 18, 1999·Proceedings of the National Academy of Sciences of the United States of America·L V HooperJ I Gordon
Jul 13, 2002·Proceedings of the National Academy of Sciences of the United States of America·Guy TheraulazJean-Louis Deneubourg
Nov 23, 2012·Interface Focus·David J T SumpterAndrea Perna
Jul 1, 1997·Clinical Microbiology Reviews·O Lortholary, B Dupont
Dec 5, 1998·Microbiology and Molecular Biology Reviews : MMBR·P G FalkJ I Gordon

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