Treatment Options in Infections Following Pediatric Hematopoietic Stem Cell Transplantation

Nazan SARPERa , Sema AYLAN GELENa

aKocaeli University Faculty of Medicine, Division of Pediatric Hematology, Kocaeli, Türkiye

ABSTRACT

Infections account for a considerable risk of morbidity and mortality among hematopoietic stem cell transplantation (HSCT) recipients. Because patients have central venous catheters, neutropenia continues for about two weeks following conditioning chemotherapy, reconstitution of T and B lymphocytes and natural killer cells in allogeneic transplantation takes time, immunosuppressants are applied for at least 4-6 months after transplantation, if chronic graft versus host disease develops, the duration of immunosuppression is prolonged. Gram-negative bacteria, gram-positive bacteria, invasive fungi, and viruses are the causative agents. Candida and Aspergillus species are the leading fungal infection agents. Cytomegaloviruses affect any organ, BK virus reactivation cause severe hemorrhagic cystitis and kidney failure, and Ebstein Barr virus reactivation causes post-transplant lymphoproliferative disease. In tranplant patients, prophylactic and pre-emptive treatments are also applied. Hepa-filtered patient rooms, isolation of the patients, and compliance with hygiene rules cannot completely prevent infections, and resistant microorganisms pose a serious problem.

Keywords: Bacterial infections and mycoses; bone marrow transplantation; cytomegalovirus infections; pulmonary aspergillosis; systemic candidiasis

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