Infectious complications of stem cell transplantation

Stem cell transplantation is a procedure used to treat and potentially cure a number of conditions including hematologic malignancies, testicular cancer, autoimmune disorders, and hemoglobinopathies. In sum, the most frequent cause of transplant-related mortality is infectious in nature. The most critical phase for infections is the neutropenic period shortly after transplant where prophylactic measures must be taken to prevent bacterial, fungal, and viral infections. Post engraftment, prophylactic measures can be employed to prevent infectious complications such as Pneumocystis jiroveci pneumonia and zoster and fungal infections in those on immunosuppressants. Allogeneic recipients may have donor-acquired or be carriers of cytomegalovirus, and pre-emptive surveillance is used, reserving therapy for rising levels. Post-transplant vaccination guidelines have also been developed.