Update on management of infections in cancer and stem cell transplant patients

Annals of Hematology
Stefan Neuburger, Georg Maschmeyer

Abstract

Infections are the most important causes of morbidity and mortality in patients with aggressive malignancies and those undergoing allogeneic stem cell transplantation. The introduction of new therapeutic approaches including the use of nucleoside analogs and of monoclonal antibodies to CD20 and CD52 and the increased use of matched unrelated stem cell donors has resulted in new challenges with regard to systemic viral and fungal infections. In patients with bacterial infections, emergence of resistance to formerly widely used antibiotics as well as a shift of causative pathogens towards a predominance of multi-resistant gram-positive cocci has to be taken into consideration. In high-risk neutropenic patients with fever of unknown origin, prompt empiric monotherapy with piperacillin-tazobactam, cefepime, ceftazidime, or a carbapenem is mandatory. In patients with lung infiltrates, early preemptive intervention with an antifungal active against aspergilli is recommended, whereas in patients with catheter-related, skin or soft tissue infections, preemptive addition of a glycopeptide shows a high response rate. The prompt preemptive use of ganciclovir or foscarnet in allogeneic stem cell transplant recipients can reliably be guided...Continue Reading

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Citations

Feb 11, 2010·International Journal of Hematology·Akimichi OhsakaUNKNOWN Japan Society of Transfusion Medicine and Cell Therapy, Granulocyte Transfusion Task Force
Sep 9, 2009·BMC Medicine·Walter J F M van der VeldenJ Peter Donnelly
Apr 28, 2009·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Maarten van VlietNicole M A Blijlevens
Aug 4, 2009·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Lennert SlobbeBart J A Rijnders
Jul 4, 2007·Transplant Infectious Disease : an Official Journal of the Transplantation Society·K A Al-AnaziF I Al-Mohareb
Sep 10, 2014·British Journal of Haematology·Walter J F M van der VeldenNicole M A Blijlevens
Jan 29, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Dimitrios P KontoyiannisKieren Marr
Apr 11, 2008·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Jan Borysowski, Andrzej Górski
May 24, 2019·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Bo-Ra ChaeYoon-Seon Lee

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