The University of Texas MD Anderson Cancer Center, Houston, Texas.
Memorial Sloan Kettering Cancer Center, New York, New York.
Transplant Cell Ther. 2021 May;27(5):359-362. doi: 10.1016/j.jtct.2021.01.024.
As an alternative stem cell source, cord blood (CB) has many advantages. However, delayed engraftment, lack of transferred immunity, and a significant incidence of acute graft-versus-host disease renders CB transplant (CBT) recipients at high risk of infectious complications. This guidance written by CBT and infectious disease experts outlines evidence-based recommendations for the prevention and treatment of opportunistic infections in adult patients undergoing CBT. Topics addressed include bacterial, fungal, viral, pneumocystis jirovcii and toxoplasmosis prophylaxis, suggested PCR monitoring for viruses, therapy for the most commonly encountered infections after CBT. We review key concepts including the recent important role of letermovir in the prevention of CMV reactivation. In instances where there is a paucity of data, practice recommendations are provided, including the duration of antimicrobial prophylaxis.
作为一种替代的干细胞来源，脐带血（CB）有许多优势。然而，延迟的植入、缺乏转移的免疫以及急性移植物抗宿主病的高发生率使 CB 移植（CBT）受者面临严重的感染并发症风险。本指南由 CBT 和传染病专家编写，概述了成人 CBT 患者中机会性感染的预防和治疗的循证建议。涵盖的主题包括细菌、真菌、病毒、卡氏肺孢子虫和弓形体病的预防、建议对病毒进行 PCR 监测、CBT 后最常见感染的治疗。我们回顾了关键概念，包括更昔洛韦在预防 CMV 再激活方面的近期重要作用。在数据缺乏的情况下，提供了实践建议，包括抗菌预防的持续时间。
