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فارسی
Infection is one of the common complications of patients undergoing hematopoietic stem cell transplantation (HSCT).The initial reconstruction of the immune system usually begins a few weeks after the transplantation of hematopoietic stem cells, but its complete reconstruction in terms of number and function requires months and even years. The innate immune system, such as neutrophils, regenerates in the first month after transplantation.
The prevalence of bacterial infections in autologous transplant patients is 5-10% and in allogeneic transplant patients 20-50%, and they are associated with increased complications and mortality.
Bacterial infections are more common in the interval before transplantation, which is called the neutropenic phase, and fungal and viral infections may appear in the neutropenic phase or later in the post-transplant phase. The most common viral infections are related to viruses that are in the latent phase and are activated after transplantation due to immune deficiency, such as the herpes family of viruses.
The incidence of infection and GVHD are directly related, because to prevent GVHD, patients take immune system suppressing drugs as prevention, and the use of these drugs can lead to the activation of latent viruses. Also, the complications of GVHD, which can lead to organ damage such as skin and mucus, increase the possibility of infection.
At the same time, viral infections such as herpes simplex virus (HSV), respiratory and intestinal viruses, HHV-6 (human herpes virus-6) and fungal infections, mainly Candida and Aspergillus species, are common.
Infection after transplantation
After three months of transplantation and development of the innate immune system, the probability of bacterial infection decreases in terms of number and function, but patients are still susceptible to viral infections, including the respiratory cytomegalovirus (CMV), BK virus. and HHV-6, which, depending on the causative organism, can cause sinus infections, central nervous system, gastrointestinal tract, liver, and reproductive tract, and fungal infections can be caused by a number of organisms such as Candida, Aspergillus, Zygomycetes, Cryptococcus and the reactivation of indigenous fungi (such as coccidioidomycosis).
These infections usually involve the pulmonary sinuses, central nervous system, liver, spleen, mouth, or integumentary system. In this phase of transplantation, parasites including Toxoplasma gondii can further affect the central nervous system or appear in a diffuse form.
Compiler and translator: Dr. Maryam Nikunejad
Read more:
Hematopoietic stem cell transplant failure
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