11/22/2023 0 Comments Autologous stem cell transplant blog![]() ![]() ĭue to indwelling venous catheters and toxicities of conditioning regimens, in particular, mucositis and gastrointestinal barrier impairment, both Gram-positive and Gram-negative bacteria may cause fever and infection after HDC/ASCT. Īfter HDC and ASCT, up to 90% of patients will experience infections, mostly presenting as fever of unknown origin (FUO). In total, the number of ASCT reported to the European Society for Blood and Marrow Transplantation in 2018 exceeds 27,750, including more than 560 for non-malignant disorders, mostly autoimmune diseases, and 1545 for solid tumours. multiple sclerosis, systemic sclerosis and Crohn’s disease. HDC and ASCT are also used in solid tumours such as neuroblastoma, sarcoma, germinal tumours and autoimmune diseases e.g. High-dose chemotherapy (HDC) and autologous stem cell transplantation (ASCT) constitute a standard of care in the treatment of heamatologic malignancies, in particular, multiple myeloma, malignant lymphoma and acute myeloid leukaemia. Fluoroquinolone prophylaxis is recommended to prevent bacterial infections, although a survival advantage has not been demonstrated. Thus, AGIHO only supports this technique with marginal strength. Data do not support a benefit of protective room ventilation e.g. Invasive fungal diseases are less frequent after HDC/ASCT, therefore, primary systemic antifungal prophylaxis is not recommended. Cotrimoxazole for the prevention of Pneumocystis jirovecii is supported. Prevention of VZV reactivation by vaccination is strongly recommended. For patients with HBs antigen and/or anti-HBc antibody positivity, HBV nucleic acid testing is strongly recommended for 6 months after HDC/ASCT or for the duration of a respective maintenance therapy. In addition to HBV and HCV, HEV screening is nowadays mandatory prior to ASCT. This guideline not only focuses on patients with haematological malignancies but also addresses the specifics of HDC/ASCT patients with solid tumours or autoimmune disorders. To ensure the safety of high-dose chemotherapy and autologous stem cell transplantation (HDC/ASCT), evidence-based recommendations on infectious complications after HDC/ASCT are given. ![]()
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